Point-of-Care Ultrasound Could Streamline Workflow of Limping Children Presenting to the Pediatric Emergency Department

Abstract

Objective: This study assessed whether the use of hip Point of Care Ultrasound (POCUS), enabling bedside evaluation of hip effusion, among limping children presenting to the Pediatric Emergency Department (PED) contributed to shortening the length of stay and reduced the use of auxiliary tests. Methods: This retrospective study included children ages 1-18 years who presented to the PED in a single medical center between 2015-2019, with a chief complaint of limping and who underwent hip POCUS. The control group included children who underwent evaluation without the use of hip POCUS. The primary measurement was total length of stay in the PED and the use of imaging and blood work. Results: A total of 220 patients were included in the study group and 191 in the control group. The groups were similar in epidemiologic characteristics and clinical presentation. the ED Length of Stay in the POCUS group was significantly shorter than the control group (p<0.0001), especially among children with a diagnosis of transient synovitis. Use of auxiliary tests was also significantly reduced in the POCUS group. Conclusions: Using hip POCUS when evaluating patients presenting to the PED with a complaint of limping or limb pain reduced the length of stay and decreased the use of auxiliary tests, especially among children with a diagnosis of transient synovitis.