小児化膿性股関節炎と単純性股関節炎の鑑別

Differentiation between Septic Arthritis and Transient Synovitis of the Hip in Children

　小児化膿性股関節炎と単純性股関節炎の鑑別診断において有用な予測因子を知ることが目的である．対象は化膿性股関節炎6例と単純性股関節炎30例である．この2群において，年齢，男女比，有症状期間，発熱，先行感染，歩行不能の有無，採血データ(WBC，CRP)およびCaird予測因子5項目の該当率を比較した．有意差があった項目は，発熱，WBC，CRP，Caird予測因子5項目の該当率であった．両股関節炎に対しては，個々の因子では鑑別診断が困難であるが，いくつかの因子を組み合わせることで優れた予想が可能となる．

　The purpose of this study was to determine the value of presenting variables (age, male gender, duration of symptoms, temperature, history of chills, non-weight bearing, leukocyte count, serum C-reactive protein level), and Caird's predictive factors in making the differential diagnosis between septic arthritis and transient synovitis of the hip in children.　Six patients with septic arthritis of the hip and 30 patients with transient synovitis of the hip were the subjects of the analysis.　The septic arthritis patients who had differed significantly from the transient synovitis patients in regard to fever (＞38.5℃), leukocyte count, serum C-reactive protein level, and Caird's predictive factors.　Evaluation of several factors in combination may provide excellent diagnostic performance in differentiating between septic arthritis and transient synovitis of the hip in children.