Diagnostic Accuracy of Point-of-Care Ultrasound for Hip Effusion: A Multicenter Diagnostic Study.

IF 5 1区医学 Q1 EMERGENCY MEDICINE

Annals of emergency medicine Pub Date : 2025-06-07 DOI:10.1016/j.annemergmed.2025.04.033

Ruchika Mohla Jones, Laurie Malia, Peter J Snelling, Antonio Riera, William Mak, Douglas Moote, Michael Brimacombe, Henry Chicaiza

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引用次数: 0

Abstract

Study objective: To determine the diagnostic accuracy of point-of-care ultrasound (POCUS) performed by pediatric emergency physicians for the diagnosis of hip effusion.

Methods: This multicenter, prospective study was conducted in 5 pediatric emergency departments (PEDs) in the United States and Australia from October 2019 to October 2023. Children aged 18 years and younger who presented to the PED with clinical presentation requiring radiology-performed ultrasound (RADUS) for evaluation of a hip effusion were eligible. Participants received POCUS by pediatric emergency physicians credentialed to perform hip ultrasound and RADUS of both hips. Physicians categorized their POCUS findings as "yes" or "no" for the presence of hip effusion based on standard measurement definition. The primary outcome was the diagnostic accuracy of POCUS using RADUS as the reference standard in diagnosing hip effusion.

Results: A total of 161 participants, aged 2 months to 15 years, were enrolled (mean age 62.4 ± 3.1 months), with 322 hips scanned. A total of 18 credentialed pediatric emergency physicians enrolled the participants, with 3 physicians accounting for enrollment of 99/161 (61.5%) of the subjects. For the 3 high-volume pediatric emergency physicians, POCUS had a sensitivity of 98.1% (95% confidence interval [CI] 88.8% to 99.9%) and specificity of 97.8% (95% CI 86.8% to 99.9%). Among the remaining 15 physicians, POCUS had a sensitivity of 83.3% (95% CI 61.8% to 94.5%) and specificity of 97.4% (95% CI 84.6% to 99.9%). POCUS identified 77 hip effusions and RADUS identified 82 hip effusions. In per hip analysis, POCUS had a sensitivity of 89.3% (95% CI 80.6 to 95.0%) and specificity of 99.2% (95% CI 97.0 to 99.9%).

Conclusion: POCUS had high sensitivity and specificity for diagnosing hip effusion in children when performed by a small group of pediatric emergency physicians with focused training, suggesting that accurate diagnosis may be feasible in similarly trained individuals.

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即时超声诊断髋关节积液的准确性：一项多中心诊断研究。

研究目的：探讨儿科急诊医师使用即时超声（POCUS）诊断髋关节积液的准确性。方法：本多中心前瞻性研究于2019年10月至2023年10月在美国和澳大利亚的5个儿科急诊科（ped）进行。年龄在18岁及以下的儿童，在PED就诊时，临床表现需要radiography -performed ultrasound （RADUS）来评估髋关节积液，均符合条件。参与者接受了由有资格进行髋关节超声和双髋关节RADUS的儿科急诊医生进行的POCUS。根据标准测量定义，医生将POCUS结果分为“是”或“否”。主要观察结果为使用RADUS作为髋关节积液诊断参考标准的POCUS诊断准确性。结果：共纳入161名参与者，年龄2个月至15岁（平均年龄62.4±3.1个月），扫描了322个髋关节。共有18名有资格的儿科急诊医生入组，其中3名医生占入组受试者的99/161（61.5%）。对于3名高容量儿科急诊医生，POCUS的敏感性为98.1%(95%可信区间[CI] 88.8%至99.9%)，特异性为97.8% （95% CI 86.8%至99.9%）。在其余15名医生中，POCUS的敏感性为83.3% (95% CI 61.8% ~ 94.5%)，特异性为97.4% （95% CI 84.6% ~ 99.9%）。POCUS鉴定出77例髋关节积液，RADUS鉴定出82例髋关节积液。在每个髋部分析中，POCUS的敏感性为89.3% (95% CI 80.6 - 95.0%)，特异性为99.2% （95% CI 97.0 - 99.9%）。结论：POCUS在诊断儿童髋关节积液方面具有很高的敏感性和特异性，当由一小群接受过重点培训的儿科急诊医生执行时，这表明在接受过类似培训的个体中，准确诊断可能是可行的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of emergency medicine 医学-急救医学

CiteScore

8.30

自引率

4.80%

发文量

819

审稿时长

20 days

期刊介绍： Annals of Emergency Medicine, the official journal of the American College of Emergency Physicians, is an international, peer-reviewed journal dedicated to improving the quality of care by publishing the highest quality science for emergency medicine and related medical specialties. Annals publishes original research, clinical reports, opinion, and educational information related to the practice, teaching, and research of emergency medicine. In addition to general emergency medicine topics, Annals regularly publishes articles on out-of-hospital emergency medical services, pediatric emergency medicine, injury and disease prevention, health policy and ethics, disaster management, toxicology, and related topics.