Residual hip dysplasia in children: osseous and cartilaginous acetabular angles to guide further treatment-a pilot study
JOURNAL OF ORTHOPAEDIC SURGERY AND RESEARCH
Authors: Merckaert, Sophie Rosa; Pierzchala, Katarzyna; Bregou, Aline; Zambelli, Pierre-Yves
Abstract
Purpose In case of residual hip dysplasia (RHD) in children, pelvic radiographs are sometimes insufficient to precisely evaluate the entire coverage of the femoral head, when trying to decide on the need for further reconstructive procedures. Methods This study retrospectively compares the bony and the cartilaginous acetabular angle of Hilgenreiner (HTE) of 60 paediatric hips on pelvic MRI separated in two groups. Group 1 included 31 hips with RHD defined by a bony HTE > 20 degrees. Group 2 included 27 hips with a HTE < 20 degrees. They were compared by introducing a new ratio calculated from the square of cartilaginous HTE above the bony HTE on frontal MRI. The normal upper limit for this acetabular angle ratio was extrapolated from the published normal values of cartilaginous HTE and bony HTE in children. Results The acetabular angle ratio was statistically significantly increased in the hips with RHD with a mean value of 7.1 +/- 4.7 compared to the hips in the control group presenting a mean value of 2.1 +/- 1.9 (p < 0.00001). Conclusions This newly introduced ratio seems to be a helpful tool to orientate the further treatment in children presenting borderline RHD.
Acute Rheumatic Fever Presenting as a Mimicker of Septic Arthritis
CUREUS
Authors: Achebe, Ikechukwu; Hussain, Kifah; Abraham, Annette; Asotibe, Jennifer C.; Shaka, Hafeez
Abstract
Acute rheumatic fever (ARF) describes the non-suppurative and autoimmune inflammation of joint, muscle, and fibrous tissue that occurs after group A streptococcal (GAS) pharyngitis. This report describes a rare case of a 39-year-old male with migratory arthralgias as a presenting sign of ARF. Through this case, we review the current literature on ARF and highlight clinical and objective findings that differentiate ARF from similar presenting arthralgias, specifically post-streptococcal reactive arthritis (PSRA). With this report, we hope to increase clinical suspicion for ARF in patients with acute joint pain, as differentiating ARF from other arthritides, PSRA specifically, determines management strategy and need for secondary prophylaxis against rheumatic heart disease.