Transient synovitis

AIIMS may 2009
Q. A 7yr old boy with abrupt onset of pain in hip with hip held in abduction. Hemogram is normal. ESR is raised. What is the next line of management?
a. Hospitalize and observe
b. Ambulatory observation
c. Intravenous Antibiotics
d. USG guided aspiration of Hip

ANSWER:

Ans is D
Reason: If septic arthritis needs to be ruled out, needle aspiration of the fluid can be performed under ultrasound guidance. In transient synovitis, the joint fluid will be clear. In septic arthritis, there will be pus in the joint, which can be sent for bacterial culture and antibiotic sensitivity testing.