{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T22:44:46Z","timestamp":1774392286391,"version":"3.50.1"},"reference-count":21,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,2,17]],"date-time":"2024-02-17T00:00:00Z","timestamp":1708128000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Paediatrica"],"published-print":{"date-parts":[[2024,6]]},"abstract":"Abstract<\/jats:title>Aim<\/jats:title>To develop and validate an algorithm to rapidly distinguish transient synovitis (TS) of the hip from differential diagnoses without additional tests.<\/jats:p><\/jats:sec>Methods<\/jats:title>This retrospective cohort study included all children admitted for non\u2010traumatic limping in the emergency department at Lille University\u2010Hospital between 2016 and 2020. The gold standard was a definitive diagnosis at follow\u2010up visit. All variables associated with acute limping in children were analysed in univariate and multivariable analyses. An algorithm was then developed using recursive partitioning and validated internally on a subset of patients.<\/jats:p><\/jats:sec>Results<\/jats:title>There were 995 patients included (mean age 5.3\u2009years; males 63%); 337 had a TS including 210 confirmed at follow\u2010up visit and 354 another diagnosis. After multivariable analysis, the relevant variables for distinguishing between TS and differential diagnoses were: age 3\u201310\u2009years, absence of fever, absence of local inflammation, sudden onset of limping on awakening. An algorithm combining these variables was developed (n<\/jats:italic>\u2009=\u2009297) and validated internally (n<\/jats:italic>\u2009=\u2009175) for children >12\u2009months with limping for \u226410\u2009days, with a specificity of 98.2% and a positive likelihood ratio of 19.6. No serious differential diagnoses were missed.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>Use of this algorithm enables the diagnosis of TS without additional tests and without missing serious differential diagnoses.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apa.17144","type":"journal-article","created":{"date-parts":[[2024,2,17]],"date-time":"2024-02-17T08:04:10Z","timestamp":1708157050000},"page":"1396-1403","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Transient synovitis of the hip: Development and validation of a new diagnostic algorithm"],"prefix":"10.1111","volume":"113","author":[{"given":"Justine","family":"Benoit","sequence":"first","affiliation":[{"name":"Pediatric Emergency Department and Infectious Diseases CHU Lille Lille France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siham","family":"El\u00a0Khalifi","sequence":"additional","affiliation":[{"name":"Pediatric Emergency Department and Infectious Diseases CHU Lille Lille France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Colin","family":"Saoudi","sequence":"additional","affiliation":[{"name":"Pediatric Emergency Department and Infectious Diseases CHU Lille Lille France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claire","family":"De\u00a0Jorna","sequence":"additional","affiliation":[{"name":"Pediatric Emergency Department and Infectious Diseases CHU Lille Lille France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fran\u00e7ois","family":"Dubos","sequence":"additional","affiliation":[{"name":"Pediatric Emergency Department and Infectious Diseases CHU Lille Lille France"},{"name":"ULR2694 METRICS: \u00e9valuation des technologies de sant\u00e9 et des pratiques m\u00e9dicales Univ. Lille Lille France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,2,17]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.5704\/MOJ.1307.011"},{"issue":"2","key":"e_1_2_14_3_1","first-page":"127","article-title":"Non\u2010traumatic limping in paediatric emergencies: epidemiology, evaluation and results","volume":"62","author":"Carre\u00f1o ML","year":"2018","journal-title":"Rev Esp Cir Ortop\u00e9dica Traumatol Engl Ed"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.bpb.0000228388.32184.7f"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anpedi.2010.05.007"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/PEC.0b013e318196ea43"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-6723.2008.01144.x"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-199912000-00002"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.E.00216"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.93B11.26857"},{"issue":"10","key":"e_1_2_14_11_1","first-page":"908","article-title":"A systematic approach to the evaluation of a limping child","volume":"92","author":"Naranje S","year":"2015","journal-title":"Am Fam Physician"},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/000992289103000604"},{"issue":"3334","key":"e_1_2_14_13_1","article-title":"Transient synovitis of the hip: which investigations are truly useful?","volume":"145","author":"Dubois\u2010Ferri\u00e8re V","year":"2015","journal-title":"Swiss Med Wkly"},{"key":"e_1_2_14_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacr.2012.04.017"},{"key":"e_1_2_14_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/BPB.0b013e328363b5a3"},{"key":"e_1_2_14_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/00008480-200002000-00010"},{"issue":"5","key":"e_1_2_14_17_1","first-page":"1587","article-title":"Transient synovitis of the hip in children","volume":"54","author":"Hart JJ","year":"1996","journal-title":"Am Fam Physician"},{"key":"e_1_2_14_18_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.92B9.24286"},{"key":"e_1_2_14_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/fampra\/cmp092"},{"key":"e_1_2_14_20_1","doi-asserted-by":"publisher","DOI":"10.52628\/87.2.09"},{"issue":"2","key":"e_1_2_14_21_1","first-page":"76","article-title":"The value of conventional radiographs of the pelvis in detection of perthes disease 3 months after an episode of acute transient synovitis","volume":"229","author":"Lenoir U","year":"2017","journal-title":"Klin Padiatr"},{"key":"e_1_2_14_22_1","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-200408000-00005"}],"container-title":["Acta Paediatrica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/apa.17144","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,9]],"date-time":"2024-05-09T04:54:11Z","timestamp":1715230451000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/apa.17144"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,17]]},"references-count":21,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2024,6]]}},"alternative-id":["10.1111\/apa.17144"],"URL":"https:\/\/doi.org\/10.1111\/apa.17144","archive":["Portico"],"relation":{},"ISSN":["0803-5253","1651-2227"],"issn-type":[{"value":"0803-5253","type":"print"},{"value":"1651-2227","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,17]]},"assertion":[{"value":"2023-10-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-26","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-02-17","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}