Children frequently have benign transient synovitis (TS), which must be separated from more dangerous conditions such as septic arthritis, osteomyelitis, and pyomyositis. For a study, researchers sought to figure out the prevalence of diagnostic testing among kids with TS and the risk of undetected bacterial musculoskeletal infection.

Using the Pediatric Health Information System, they conducted a cohort analysis on kids between the ages of 1 and 10 who had been diagnosed with TS in the ED. They calculated missed bacterial musculoskeletal infection rates (defined as a new diagnosis of septic arthritis, osteomyelitis, or pyomyositis within 14 days of the initial ED visit). They discussed the first diagnostic assessment, ED care, and site-specific variations for children with TS.

They looked at 6,419 interactions from 37 hospitals. A missed bacterial musculoskeletal infection was found in 62 (1.0%, 95% CI: 0.7-1.2%) youngsters. Younger kids had missed infections than those who didn’t (median age, 2.6 vs. 4.6 years, P<0.01). With little difference between locations, serum laboratory testing was done in 76% of contacts. Hip ultrasound usage varied significantly by the site (2 to 92%), and it has grown with time (from 42% in 2016 to 62% in 2021).

The extensive observational research, missing bacterial musculoskeletal infection in children with TS was uncommon, but it was more typical in younger children. Uncertainty exists on the ideal radiographic and blood test protocol, particularly ultrasound, to identify TS from more severe illness.

Reference: sciencedirect.com/science/article/abs/pii/S0735675722005241