AI Article Synopsis
- A 12-year-old boy visited the emergency department with worsening right hip pain over five days and difficulty walking, without any physical injury.
- Tests showed elevated inflammatory markers but a normal white blood cell count, raising concerns for a possible infection.
- Joint aspiration revealed a high white blood cell count and a mass was found on MRI, which was later identified as a rare tenosynovial giant cell tumor, emphasizing the importance of accurate diagnosis to avoid unnecessary surgeries.
Article Abstract
A 12-year-old boy presented to the pediatric emergency department with a 5-day history of atraumatic, progressively worsening right hip pain and inability to ambulate. He was afebrile and had elevated inflammatory markers (Erythrocyte Sedimentation Rate [ESR]: 42 mm/hr, C-Reactive Protein [CRP]: 6.6 mg/dL) with a normal white blood cell count of 6050 cells/mm3. Given the clinical concern for septic arthritis, joint aspiration of the right hip was done and demonstrated a bloody appearance with a WBC count of 54,999 cells/mm3 and RBC count of 7,000 cells/mm3. MRI of the right hip demonstrated an intra-articular mass suggestive of tenosynovial giant cell tumor/pigmented villonodular synovitis. Subsequent biopsy and excision of the mass confirmed the diagnosis. The acute presentation of tenosynovial giant cell tumor with features mimicking septic arthritis is uncommon. This rare presentation of an already uncommon diagnosis should be considered in a child with an equivocal presentation for severe hip pain because misdiagnosis may lead to unnecessary or inadequately planned surgical treatment of the condition.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9173515 | PMC |
| http://dx.doi.org/10.5435/JAAOSGlobal-D-22-00011 | DOI Listing |
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