Hip effusion: compare the capsule distance

Question 1Which probe orientation do you use to scan the hip for an effusion?

1. aAlong the long axis of the femoral neck
2. bPosterior to the joint
3. cTransverse across the inguinal ligament
4. dOver the greater trochanter

Question 2In a child, which finding defines a hip effusion?

1. aAny visible fluid in the joint
2. bIncreased colour flow in the femoral head
3. cA capsule-to-neck distance under 2 mm
4. dA capsule-to-neck distance over 5 mm, or more than 2 mm wider than the other hip

Question 3A febrile 6-year-old refuses to walk and has a right hip effusion. What do you do?

1. aRepeat the scan in a week
2. bGive ibuprofen and review in clinic
3. cArrange urgent orthopaedic review, as septic arthritis must be excluded
4. dDiagnose transient synovitis and discharge

Question 4What does the capsule look like when there is an effusion?

1. aLifted off the femoral neck and bulging outwards
2. bThinner than on the other side
3. cClosely applied to the neck and concave
4. dInvisible

Question 5Where do the femoral vessels lie in relation to the hip joint when you plan an aspiration?

1. aMedial to the joint
2. bDirectly over the femoral neck
3. cLateral to the joint
4. dBehind the femoral head