Accuracy of Pediatric Emergency Medicine Providers in Diagnosing Hip Effusions Using Point of Care Ultrasound

Completed

Brief Summary: The purpose of this study is to determine if pediatric emergency medicine providers can accurately diagnose a hip effusion using point-of-care ultrasound (POCUS) compared to radiology ultrasound (RADUS).

Detailed Description: The purpose of this study is to determine that the accuracy of trained pediatric emergency medicine providers to diagnose hip effusion using point-of-care ultrasound (POCUS) is non-inferior to the reference standard of radiology ultrasound (RADUS). Additionally, the investigators seek to compare how POCUS performs against other clinical tests or investigations for the diagnosis of septic arthritis. The investigators hypothesize that trained EM providers will be able to diagnose hip effusions with high (\>90%) accuracy compared to studies conducted by the Department of Radiology.

Recruitment & Eligibility

Inclusion Criteria

Age 18 years or younger
Clinical presentation necessitating hip ultrasonography as determined by the evaluating clinician
Study physician available at the time of presentation to ED
Patient or legal guardian provides consent

Exclusion Criteria

Children who present when a study physician is not available or those for whom consent is not given.
Children who have had hip ultrasound imaging prior to their ED visit. Children with prior hip/pelvis x-rays will not be excluded.

Primary Outcome Measures

Name	Time	Method
The presence of absence of a hip effusion.	From the time the radiologist reviews the ultrasound as performed by the radiology technician during the emergency department visit, through study completion, average of 2 years.	The presence or absence of an effusion as determined by the Radiologist on both the affected and unaffected sides.
The presence or absence of a hip effusion.	From the time the point-of-care ultrasound is performed by the physician during the emergency department visit through study completion, average of 2 years.	The presence or absence of an effusion as determined by the pediatric emergency medicine physician performing the point-of-care-ultrasound study on both the affected and unaffected sides (i.e. right hip and left hip).

Secondary Outcome Measures

Name	Time	Method
The size of the effusion.	From the time the point-of-care ultrasound is performed by the physician during the emergency department visit to study completion, average of 2 years	As measured by the pediatric emergency medicine provider in millimeters.
The location of the measurement of the effusion.	Upon chart review: between the time the measurement was obtained in the emergency department up to six weeks later when the chart is reviewed by primary investigator.	Pediatric emergency medicine physicians will measure an effusion at two designated locations. One location is based off of current published literature whereas the second is to provide a comparison to determine if the exact location alters the final diagnosis (effusion or no effusion). Investigators will determine whether the location along the angle of the neck affects the measurement obtained when compared with the current standard practice of measuring fluid along the widest part of the femoral neck.

Locations (6): Gold Coast Hospital and Health Service
🇦🇺
Southport, Queensland, Australia
Yale University
🇺🇸
New Haven, Connecticut, United States
Ruchika M Jones
🇺🇸
Hartford, Connecticut, United States
Newark Beth Israel Medical Center
🇺🇸
Newark, New Jersey, United States
Columbia University Medical Center
🇺🇸
New York, New York, United States
Cohen Children's Medical Center
🇺🇸
New Hyde Park, New York, United States