Differential Diagnosis and CPT |
Pathophysiology |
Lab Test |
Diagnostic Test |
Medications |
Patient Education |
|
| 1. |
Transient synovitis ICD 10 CODE- M67.351 |
Non-specific acute inflammation & hypertrophy of the synovium of a joint from viral infections, trauma, reaction to certain medications/vaccines & allergic reactions causing arthralgia & arthritis |
Imaging tests Blood work & Serological tests |
Synovial membrane biopsy, Hip Radiography and Ultrasonography, FBC,CRP,ESR The FABER/ Patrick Test, Ultrasound guided hip aspiration |
Bed rest, Heat therapy, Massage Hip skin traction at 45 degrees, NSAIDs e.g. Ibuprofen 200 mg every 8 hours for 1 week, Painkillers e.g. Paracetamol 320mg/10ml every 6 hours, Corticosteroids or DMARDs in severe cases |
Limit physical activity Bed rest Avoid weight bearing |
| 2. |
Septic Arthritis ICD 10 CODE- M00.861 |
Joint inflammation following pathological invasion by an infectious agent from blood, via trauma or local infection accompanied by pain, fever, limited use of the joint and pseudo paralysis |
Blood work Imaging tests |
Joint fluid aspiration & culture, FBC, CRP, ESR Joint radiography, Ultrasonography, MRI |
I.V then oral Antibiotic therapy vary depending on isolated organism, Surgical drainage of pus, Joint immobilization with splint, plaster or traction, Bed rest, Pain management |
Limit physical activity Bed rest Avoid weight bearing |
| 3. |
Legg-Calve-Perthe’s Disease ICD 10 CODE- M91.11 |
A type of Osteochondritis resulting from Idiopathic Osteonecrosis of the head of a developing femur due to disruption of blood flow causing weakening & loss of mass of the femoral head | Imaging Tests |
Radiography, Technetium Bone Scan, MRI, Ultrasonography, Bone scintigraphy |
Pain management, Femur traction, Bracing with thigh cuffs & waist belts, Custom orthotics & assisted walking devices, Physiotherapy, Surgical intervention, Use of an external fixator, Controlled exercises e.g. swimming, cycling |
Avoidance of contact sports Refrain from aggressive physical activity Avoid weight bearing Adequate bed rest |
| 4. |
Acute Osteomyelitis ICD 10 CODE- M86.171 |
Bacterial infection of the bone via hematogenous seeding, inoculation after traumatic injury or from septic arthritis or cellulitis in surrounding tissue | Blood work, Imaging tests |
Blood culture, ESR, CRP, FBC, MRI, Technetium Bone Scan, Bone biopsy, CT Scan, Precalcitonin levels, Scintigraphy, Radiography |
I.V Antibiotic therapy depending on the nature of organism followed by a full dose oral therapy e.g. Clindamycin, Cephalosporins with good bone penetration, NSAIDs for pain & inflammation |
Avoidance of contact sports Refrain from aggressive physical activity Avoid weight bearing Adequate bed rest |
References
Anil Agarwal, A. N. (2016, August). Bone and Joint Infections in Children: Septic Arthritis. The Indian Journal of Pediatrics, 83 (8), 825-833.
Delegate your assignment to our experts and they will do the rest.
Eich GF, U. F. (1999, November). The painful hip: evaluation of criteria for clinical decision-making. European Journal of Pediatrics, 158 (11), 923-928.
Heikki Peltola, M. P. (2014, January 23). Acute Osteomyelitis in Children. The New England Journal of Medicine , 352-360.
JJ, H. (1996, October). Transient synovitis of the hip in children. American Family Physician, 54 (5), 1587-1591.
PC, C. (2014, December). Transient synovitis,septic hip and Legg- Calve-Perthes disease: an approach to the correct diagnosis. Paediatric Clinicsof North America, 61 (6), 1109-1118.
TT, D. (2000, February). Transient synovitis as a cause of painful limps in children. Curr Opin Paediatric, 12 (1), 48-51.
