• The Korean Journal of Nuclear Medicine
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• v.19 no.1
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• pp.73-75
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• 1985

Acute transient synovitis of the hip presents clinically pain and limping. But in the majority of the cases, definite positive findings are not manifest in roentgenogram in its early phase. However radionuclide bone imaging combines with the assessment of vascularization and bone tracer uptake is of great value in solving this diagnostic problem. The materials for this study consisted of 29 children with acute transient synovitis of the hip, characterized by symptoms and physical signs of an arthritis, negative X-ray findings and disappearance of all symptoms and signs within a short period of time. They were twenty males and 9 females and age ranged from 1 to 12 years. We took pelvic reontgenogram in AP and frog-leg views. After intravenous bolus injection of 10 to 15 mCi of $^{99m}Tc-methylene$ diphosphonate, 24 sequential image of the pelvis was taken at 2-second interval for blood flow study. The scintigrams were made using a gamma camera with high resolution parallel hole collimator. Blood pool imaging was obtained at 2 minutes after tracer administration. After 3 hours, static images were taken and then closeup image of the hip using pin-hole collimator was followed. The results were as follows: 1) Bone scintigram was much more sensitive than conventional roentgenogram in diagnosis of acute transient synovitis of the hip. 2) Three-phase imagings showed increased vascular activities in blood pool scintigrams in 96%. 3) Pin-hole imaging showed increased tracer uptake in the regional bones of the hip, par ticularly in the medial aspect of femoral head and acetabulum. 4) We confirmed that three-phase imaging reinforced with pin-hole technique were very useful in diagnose of acute transient synovitis of the hip.

• The Journal of Pediatrics of Korean Medicine
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• v.37 no.4
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• pp.34-52
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• 2023

Objective This study aimed to evaluate the effect of herbal medicines on transient hip synovitis (TSH) in children. Methods We searched 10 Korean, English, Japanese, and Chinese databases for studies published up to September 19, 2023. Randomized controlled trials (RCTs) evaluating the effect of herbal medicines on TSH levels in children were included. The Cochrane risk of bias was used to evaluate the quality of the studies. A meta-analysis was conducted according to outcome measurements, such as total effective rate (TER), visual analog score (VAS), time to pain relief, and hip joint mobility disorder disappearance time, using the Review Manager website. Results Eleven RCTs were included in this study. TER in the treatment group was significantly higher than in the control group. The duration of pain relief was significantly shorter in the treatment group than in the control group. The VAS score of the treatment group was significantly lower than that of the control group, although the statistical heterogeneity was substantial. The hip joint mobility disorder disappeared in the treatment group treated with external therapy, which was significantly shorter than in the control group. Regarding safety, two of the 11 studies reported that there were no adverse events. Conclusions Herbal medicines are effective in the treatment of TSH in children. However, the safety of herbal medicines should be carefully considered due to the lack of data.

• Journal of the Korean Society of Radiology
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• v.85 no.3
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• pp.531-548
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• 2024

Developmental dysplasia of the hip is a condition characterized by hip joint instability due to acetabular dysplasia in infancy, necessitating precise ultrasound examination. Legg-Calvé-Perthes disease is caused by a temporary disruption in blood flow to the femoral head during childhood, progressing through avascular, fragmentation, re-ossification, and residual stages. Slipped capital femoral epiphysis is a condition where the femoral head shifts medially along the epiphyseal line during adolescence due to stress, such as weight-bearing. Differentiating between transient hip synovitis and septic arthritis may require joint fluid aspiration. Osteomyelitis can be associated with soft tissue edema and osteolysis. When multiple lesions are present, it is essential to distinguish between Langerhans cell histiocytosis and metastatic neuroblastoma. This review will introduce imaging techniques and typical findings for these conditions.