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Differentiation Between Septic Arthritis and Transient Synovitis of the Hip in Children
Pablo Yagupsky, MD1
1 Soroka University Medical CenterBen-Gurion University of the NegevBeer-Sheva 84104, Israelyagupsky@bgumail.bgu.ac.il
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The author did not receive grants or outside funding in support of his research or preparation of this work. He did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the author is affiliated or associated.

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2005 Feb 01;87(2):459-460
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To The Editor:I read with interest the article "Differentiation Between Septic Arthritis and Transient Synovitis of the Hip in Children with Clinical Prediction Algorithms" (2004;86:956-62), by Luhmann et al., in which the distribution of a variety of demographic, clinical, and laboratory parameters in children with septic arthritis or transient synovitis of the hip was compared. The authors found that the two populations differed in terms of history of fever, erythrocyte sedimentation rate values, white blood-cell count in the synovial fluid, and cellular composition of the peripheral blood and joint fluid leukocytes. Of the forty-seven children included in the group with composite septic arthritis, twenty had either a positive synovial fluid culture or a positive blood culture and a synovial fluid white blood-cell count of =50 × 109/L ("true septic arthritis") and twenty-seven had negative blood or synovial fluid cultures and a synovial fluid white blood-cell count of =50 × 109/L ("presumed septic arthritis"). Although no explicit criteria for defining a positive bacteriological culture were stated in the Materials and Methods section of the article, examination of the list of organisms isolated from patients in the group with true septic arthritis raises some concerns.
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