Initial diagnostic approach of the irritable hip in childhood: is ultrasound really useful?

: The acutely painful hip is a common complaint in childhood and has numerous significant causes. This prospective study explored the use of ultrasound as an adjunct to medical history and clinical examination in children with an irritable hip attending a department of orthopaedic emergencies over the course of 8 months. One hundred thirty four children met the inclusion criteria. A provisional diagnosis was made after history, clinical examination and ultrasound scan and this initial diagnosis was compared with the final diagnosis after a 3-year follow-up. The nature and number of further investigations required to reach the final diagnosis were reviewed. The use of ultrasound reduced the number of early radiographs by 84% and in conjunction with history and clinical findings had a diagnostic accuracy of 92%.