The rational use of a local scoring system to differentiate between septic arthritis & transient synovitis in children

摘要

In order to study the specificity and the sensitivity of a locally produced scoring system to differentiate between septic arthritis and transient synovitis at initial presentation, the records of 33 cases of irritable hip, 24 males and nine females, in the Pediatric departments of King Hussein Medical Center and Prince Rashid Military Hospital, Jordan, were reviewed retrospectively. Septic arthritis was diagnosed in nine patients all of whom scored nine or above; none were missed with false low scores. The sensitivity and specificity for this local scoring system were calculated to be 100% and 91.66% respectively. The positive predictive value was 81.81%. Conclusion: There is a significant overlap in the temperature; erythrocyte sedimentation rate and WBC count in children with toxic synovitis and septic arthritis of the hip. We found our local scoring system useful in predicting the patients at high or moderate risk of septic arthritis thus avoiding unnecessary invasive investigations and unjustified prolonged admissions and antimicrobial treatment.