Hip Pocus for the Evaluation of Limping Children in the ED

Backround: limping or refusal to bear weight is a common complaint among children presenting to Pediatric Emergency Department (PED). It may be challenging to evaluate, especially among toddlers and non verbal children. 

Point of care ultrasound (POCUS) has many clinical applications, including hip POCUS that enableas bedside evaluation of hip effusion. 

Our  study asessed whether the use of hip POCUS has contributed to shortening patient’s  stay in the PED and reduced the use of auxiliary tests.

Methods: A retrospective study involving children aged 2-18 years who presented to Meir hospital’s PED with a chief complaint of limping between the years 2015-2019. The study group included children who underwent hip POCUS as part of thier ED evaluation.

The control group included children who underwent evaluation without use of hip POCUS.

The primary outcome was total care duration in the PED and the use of additional diagnostic workup.

Results: 220 patients were included in the study goup , 191 patients were included in the control group. The groups didn’t differ in their epidemiologyc charachteristics or clinical presentation . the POCUS group`s ED length of stay was signufically shorter than the control group (p<0.0001) . Use of auxiliary tests was significally redused in the POCUS group.

Conclusion: the use of hip POCUS  as part of evaluating patients presenting to the PED with the complaint of  limping or limb pain reduces legth of stay and streamlins emergency room resources.