DOPPLER BASED COMPARISON OF TRANSIENT SYNOVITIS OF THE HIP JOINT AND PERTHES‘ DISEASE

Objective: To compare the hip joint perfusion (HJP) and hip joint effusion (HJE) of affected and unaffected joints of patients with Perthes disease (PD) and transient synovitis (TS) with the help of doppler ultrasound. Methodology: This study was conducted at Children Clinical Hospital No.1, Ivanovo, Russia from 01.09.2001 to10.01.2006. One hundred and one children diagnosed as TS and PD were examined. Hip joint perfusion and hip joint effusion were measured on Doppler ultrasonic examinations, carried out with the help of duplex scanning of the vessels of the hip joints. Patient’s data was analyzed statistically by SPSS 14. Results: Out of 101 patients 59 (58.4%) children had doppler ultrasound evidence of PD, while 42 (41.6%) had TS of the hip joint. In TS, HJE was 2.9 ± 0.20 ml and 2.0 ± 0.02 ml in affected and unaffected joints respectively (p 0.01) while in PD HJE was significantly increased in stage I, II and III. HJP of medial circumflex arteries, lateral circumflex arteries, lateral ascending cervical artery and intra capsular ring was significantly decreased in affected joints of TS and PD. Increased circumflex venous flow was observed in TS and first 3 stages of PD. Three children with TS subsequently developed PD. Conclusion: Increased joint effusion is the common factor causing deterioration of perfusion both in children with TS and PD. Increased effusion in perfusion deficit hip joints may lead to development of PD in children with TS. Early diagnostic sign of the beginning of PD is subcompensated perfusion deficiency of the femoral head.