Runny nose
Definition / introduction
The runny nose is also called Coxitis fugax or transient synovitis denotes and represents an abacterial, i.e. germ-free, inflammation of the hip joint. If you translate the term Coxitis fugax, you get an accurate description of the clinical picture. Coxitis fugax means something like,volatile hip joint inflammation ".
The hip runny nose is the most common affection of the hip joint in growing age. Typically, this disease occurs between the ages of 3 and 8, whereby both younger and older children can become ill. Adults can also get a runny nose, but this is extremely rare. Hip runny nose affects boys four times more often than girls.
There is also a seasonal increase in the disease. The hip runny nose mainly occurs in the transition months in spring and autumn. A manifestation of the disease in the summer months, on the other hand, is rather rare.
The runny nose is not contagious.
causes
The cause of the development of this disease is sometimes unclear. The runny nose is often caused by one viral infection of the upper respiratory tract or des Gastrointestinal tract triggered. The hip runny nose can occur two to three weeks later than the infection. On closer inspection, however, one can see no infection in every second affected child, not even in the past weeks.
Neither familial accumulation of hip rhinitis nor familial risk factors are currently known.
There is also a connection with other hip disorders Not described. This means that hip rhinitis cannot be observed more frequently in certain hip diseases and also does not favor the development of other hip diseases.
Symptoms
Of the Runny nose usually occurs one-sided and manifests itself in around 65% of those affected Pain in the groinwhere that too hip joint can be found. This pain can be in the Thigh and in the equilateral Knee joint radiate, so that it can even come to the point that the child suddenly no longer wants to or cannot walk for no external reason.
It is typical that the symptoms suddenly, like "out of the blue“Occur. In addition, a Painful limp and a Limitation of passive and active mobility of the affected hip joint. In 85% of the cases the affected leg is held in extension, splay and rotation. Also easy fever can accompany a runny nose.
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The hip joint is one of the joints that are exposed to the greatest stress.
The treatment of the hip (e.g. hip arthrosis, hip impingement, etc.) therefore requires a lot of experience.
I treat all hip diseases with a focus on conservative methods.
The aim of any treatment is treatment without surgery.
Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.
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Signs
The typical signs of a runny nose are severe Pain in the hip area. As a rule, the pain occurs on one side, but in exceptional cases it can also occur on both sides. The pain often begins in the groin area and then radiates into the front thigh to the knee.
The children with a runny nose usually refuse to walk because of the severe pain, but if they do, they can only hobble. In addition, there is often pain when moving the leg, especially when turning it.
However, these signs occur when the patient is in good general health. Fever does not occur with a runny nose. If this is the case, this could indicate a bacterial joint inflammation and a doctor should be consulted quickly.
diagnosis
in the laboratory may show a slightly increased number as a sign of inflammation white blood cells (Leukocytosis), one Increase in the rate of blood cell sedimentation and a Increase in C-reactive protein (CRP), another inflammation value. If you suspect a runny nose you should always have one Ultrasound examination of the hip be performed. This examination method is extremely grateful for children because it neither invasive nor painful is and moreover also fast and without any radiation exposure can be carried out.
After placing the ultrasound transducer directly on the hip joint, a Joint effusion come to the representation. A joint effusion is a Build-up of fluid in the joint. This fluid is always with a runny nose sterile, that means free of any germs capable of multiplying, such as microorganisms or Viruses. However, this can only be determined in the context of a fluid withdrawal and a subsequent examination. This fluid is clear, cloudy, or bloody if you have a runny nose. In addition, the femoral head can be pushed to the side by the fluid, i.e. it can be lateralized.
In a X-ray the affected hip joint shows itself mostly inconspicuous. A so-called soft tissue shadow, an expansion of the joint capsule or the displacement of the femoral head by the Joint effusion demonstrate. Despite the usually inconspicuous findings, an X-ray can be helpful in ruling out other diseases.
Also in one Magnetic resonance imaging (MRI) would, despite the present illness, no signs of illness - except for the joint effusion - are shown.
therapy
It happens in most children with a runny nose within just a few days to a significant improvement of complaints. If symptoms persist, the symptoms of hip rhinitis become less likely and a re-evaluation of the clinical symptoms should be considered.
If you have a runny nose that should hip joint with the Joint effusion be relieved. This can be done as part of a Joint puncture happen with the liquid from the joint Will get removed. Since this means that a little fluid can be obtained and examined, a joint puncture is not only for therapy, but also to exclude a bacterial related, infectious inflammation of the hip joint.
Depending on the pain symptoms, a bed rest be observed for several days so that the hip joint relieved becomes. Also one Pain medication, for example with Paracetamol and a Stick relief the affected side can relieve the pain. However, you should consult your doctor before administering a pain reliever.
At improvement of complaints can be the burden of the hip gradually reinforced become. After three to six months a new clinical and radiological Control indicated to ensure that another clinical picture, which typically occurs at a similar age and is associated with a similar clinical picture, can be ruled out. It is the Perthes disease, a disease of the femoral head that also occurs in childhood.
Complications
Of the Hip runny nose usually heals within a few days to weeks without any consequences No persistent complaints or hip changes have been shown to date, either from or in the long term. However, 5 - 20% of the affected children will suffer from a cold hip one more time in their lifetime.
Duration of hip rhinitis
A Runny nose Usually does not require any special therapy and disappears by itself after a few days without leaving any lasting damage.
After a few days of bed rest, the sore hip be relieved for a few more days. Crutches can be used for this.
If these measures are followed, the hip runny nose is usually over after about ten to 14 days. Damage does not linger, and children usually only get a runny nose once in their lifetime. Since the general well-being of the child is not affected by a hip runny nose, the children can quickly get back on their feet after the symptoms have subsided.
