Ultrasound evaluation of the hip joint was performed in 17 patients as part of the sonographic investigation of lower abdominal pain with referred symptomatology to the groin and thigh. Sonographic features consistent with hip joint effusion were detected in 12 of the patients. In four patients with positive arthrosonogram the possibility of hip joint involvement was not considered by the examining physician. In 11 other cases, hip pathology was included in the differential diagnosis. Of these, hip involvement was confirmed by sonography in eight patients and excluded in three. Sonography was found to be a useful objective method for the confirmation or exclusion of hip joint effusion. The examination had a significant influence on the patient management for shifting the attention of the clinician from the abdomen to the hip joint in four of the cases in this series. Indexing Words: Ultrasound Hip joint Joint effusion Abdomen Acute conditions
The evaluation of acute lower abdominal pain often poses a diagnostic challenge. Effusion in the hip joint of an inflammatory or hemorrhagic nature is one of several medical conditions that may mimic situations requiring surgical intervention.'" The use of sonography in evaluating hip joint effusions has been reported by several author^.^-^
In this report we emphasize the clinical significance of sonographic assessment of the hip joint as part of the investigation of acute lower abdominal pain by correlating the clinical and so- nographic data.
MATERIAL AND METHODS
Sonography of the hip joint, groin, and pelvis was performed in 17 patients with acute lower abdominal pain. All the patients had, in addition, symptomatology referable to the inguinal and thigh regions. This included pain irradiating to that region (nine cases), positive iliopsoas sign From the Division of Diagnostic Ultrasound* and the Department of Orthopedic Rehabilitation A,