床旁超声诊断儿童髋关节积液的证据综述

This study reviews the evidence for point-of-care ultrasound (POCUS) for the detection of hip effusion in children presenting to the emergency department with atraumatic limp or hip pain. A scoping review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Review (PRISMA-ScR) guideline. PubMed, EMBASE, and the Cochrane Library databases were searched from January 2000 to October 2025. All study designs were considered. The primary outcome was diagnostic accuracy of POCUS for hip effusion, and key secondary outcomes included provider characteristics and clinical integration. Data were also charted across study, participant, and ultrasound characteristics. Thirteen studies met inclusion criteria: 3 prospective studies, 9 retrospective cohorts, and 1 case report. Studies predominately evaluated diagnostic accuracy of POCUS performed by emergency medicine physicians with variable training compared with radiology performed ultrasound, feasibility of POCUS guided hip arthrocentesis, and explored its integration into clinical decision rules. Diagnostic accuracy was high, with reported sensitivity ranging from 80% to 98% and specificity from 91% to 98%. This scoping review demonstrates that there is growing evidence that hip POCUS is a useful clinical tool for evaluation of pediatric patients presenting to the emergency department with atraumatic limp or hip pain. It has been shown to be accurate when performed by emergency physicians after variable training. Further research is required with large prospective multicenter studies to explore patient-centered outcomes and validate diagnostic pathways that incorporate POCUS.