Role of high resolution ultrasonography in diagnosing septic hip arthritis in premature neonates admitted to the neonatal intensive care unit

Abstract

Aim: The aim of this study is to evaluate the role of high resolution ultrasonography (HRUS) of the hip in premature neonates admitted to the neonatal intensive care unit (NICU) in diagnosis of septic hip arthritis. Patients and methods: This prospective study was done for twenty premature neonates having clinical and laboratory findings compatible with the diagnosis of acute septic arthritis. They were subjected to HRUS of the hip as well as US-guided aspiration and analysis of synovial fluid. Results: Hip ultrasonography showed synovial fluid containing echoes in twelve patients and was clear in six patients. Joint capsule was thickened in fourteen patients. Seventeen patients had sonographic features of septic arthritis. The sensitivity of HRUS was 93.8%, specificity 50%, positive predictive value 88.2%, negative predictive value 66.7% and the accuracy was 85%. Conclusion: HRUS is beneficial in early diagnosis of septic hip arthritis in premature neonates admitted to the NICU. It is an easy, available and rapid procedure.

Keywords

• Septic arthritis
• Neonatal ICU
• Premature
• High resolution US