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. 2000 Mar;59(3):178–182. doi: 10.1136/ard.59.3.178

Sonography for hip joint effusion in adults with hip pain

S Bierma-Zeinstra 1, A Bohnen 1, J Verhaar 1, A Prins 1, A Ginai-Karamat 1, J Lameris 1
PMCID: PMC1753083  PMID: 10700425

Abstract

OBJECTIVE—To study the prevalence of ultrasonic hip joint effusion and its relation with clinical, radiological and laboratory (ESR) findings in adults with hip pain.
METHODS—Patients (n=224) aged 50 years or older with hip pain, referred by the general practitioner for radiological investigation, underwent a standardised examination. The distance between the ventral capsule and the femoral neck, an increase in which represents joint effusion, was measured sonographically. Joint effusion was defined in three different ways: "effusion" according to Koski's definition, "major effusion", and "asymmetrical effusion" based on only individual side differences.
RESULTS—"Effusion" was present in 80 (38%), "major effusion" in 20 (9%), and "asymmetrical effusion" in 47 (22%) patients. Pain in the groin or medial thigh, pain aggravated by lying on the side, decreased extension/internal rotation/abduction/flexion, painful external rotation, and pain on palpation in the groin showed a significant relation (adjusted for age and radiological osteoarthritis of the hip) with ultrasonic hip joint effusion. "Major effusion" showed a significant relation with an increased ESR. When patients with bilateral pain and increased ESR were excluded, a side difference in the range of motion of extension of the hip was shown to be a good predictor for "asymmetrical effusion" (positive predictive value: 71%, negative predictive value: 80%).
CONCLUSION—This study showed a relatively high prevalence of ultrasonic joint effusion in adults with hip pain in general practice. Furthermore the results indicate a relation between joint effusion and clinical signs.



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Figure 1  .

Figure 1  

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The hip joint as seen during sonographic examination (anterior view).

Selected References

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