seroes-coxitis (LH Indholdsside)

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    <Content>
      <HtmlField Name="PageContent"><![CDATA[<h2>Diagnose</h2>
<h3>Diagnostiske kriterier<a href=" " data-type="book-reference" data-value="Nigrovic PA. Approach to hip pain in childhood. www.uptodate.com: Wolters Kluwer; 2021" data-value-piped="Nigrovic PA|Approach to hip pain in childhood|www.uptodate.com|Wolters Kluwer|2021" data-url="reference-link" title="Nigrovic PA. Approach to hip pain in childhood. www.uptodate.com: Wolters Kluwer; 2021">1</a><sup>,</sup><a href=" " data-type="journal-reference" data-value="Cook PC, Transient synovitis, septic hip, and Legg-Calvé-Perthes disease: an approach to the correct diagnosis.. Pediatr Clin North Am 2014;61: 1109-18" data-value-piped="Cook PC|Transient synovitis, septic hip, and Legg-Calvé-Perthes disease: an approach to the correct diagnosis.|Pediatr Clin North Am|2014|61|1109-18|25439014" data-url="reference-link" data-pubmedid="25439014" title="Cook PC, Transient synovitis, septic hip, and Legg-Calvé-Perthes disease: an approach to the correct diagnosis.. Pediatr Clin North Am 2014;61: 1109-18">2</a></h3>
<ul>
    <li>Diagnosen kan f&oslash;rst verificeres bagefter, n&aring;r patienten er rask, og andre diagnoser er udelukket</li>
    <li>Blodpr&oslash;ver, billeddiagnostik og kliniske fund er undervejs vejledende</li>
</ul>
<h3>Sygehistorie<a href=" " data-type="book-reference" data-value="Nigrovic PA. Approach to hip pain in childhood. www.uptodate.com: Wolters Kluwer; 2021" data-value-piped="Nigrovic PA|Approach to hip pain in childhood|www.uptodate.com|Wolters Kluwer|2021" data-url="reference-link" title="Nigrovic PA. Approach to hip pain in childhood. www.uptodate.com: Wolters Kluwer; 2021">1</a><sup>,</sup><a href=" " data-type="journal-reference" data-value="Cook PC, Transient synovitis, septic hip, and Legg-Calvé-Perthes disease: an approach to the correct diagnosis.. Pediatr Clin North Am 2014;61: 1109-18" data-value-piped="Cook PC|Transient synovitis, septic hip, and Legg-Calvé-Perthes disease: an approach to the correct diagnosis.|Pediatr Clin North Am|2014|61|1109-18|25439014" data-url="reference-link" data-pubmedid="25439014" title="Cook PC, Transient synovitis, septic hip, and Legg-Calvé-Perthes disease: an approach to the correct diagnosis.. Pediatr Clin North Am 2014;61: 1109-18">2</a></h3>
<ul>
    <li>Som regel halter barnet og v&aelig;rger sig&nbsp;mod at belaste det ene ben</li>
    <li>Varighed typisk f&aring; dage til en uge, men 12 % har en l&aelig;ngere sygehistorie</li>
    <li>Akutte smerter i den ene hofte, men 5 % har symptomer fra begge hofter</li>
</ul>
<h3>Kliniske fund<a href=" " data-type="book-reference" data-value="Nigrovic PA. Approach to hip pain in childhood. www.uptodate.com: Wolters Kluwer; 2021" data-value-piped="Nigrovic PA|Approach to hip pain in childhood|www.uptodate.com|Wolters Kluwer|2021" data-url="reference-link" title="Nigrovic PA. Approach to hip pain in childhood. www.uptodate.com: Wolters Kluwer; 2021">1</a><sup>,</sup><a href=" " data-type="journal-reference" data-value="Cook PC, Transient synovitis, septic hip, and Legg-Calvé-Perthes disease: an approach to the correct diagnosis.. Pediatr Clin North Am 2014;61: 1109-18" data-value-piped="Cook PC|Transient synovitis, septic hip, and Legg-Calvé-Perthes disease: an approach to the correct diagnosis.|Pediatr Clin North Am|2014|61|1109-18|25439014" data-url="reference-link" data-pubmedid="25439014" title="Cook PC, Transient synovitis, septic hip, and Legg-Calvé-Perthes disease: an approach to the correct diagnosis.. Pediatr Clin North Am 2014;61: 1109-18">2</a></h3>
<ul>
    <li>Barnet flekterer og udadroterer ofte spontant i hoften. Dette medf&oslash;rer slappere kapsel, mindre tryk og f&aelig;rre smerter</li>
    <li>Reduceret bev&aelig;gelighed i hoften, specielt abduktion, indadrotation og ekstension</li>
    <li>Normalt er barnet velbefindende, men der kan ses let feber og sj&aelig;ldent temperatur over 38,5 med almen p&aring;virkning</li>
</ul>
<h3>Supplerende unders&oslash;gelser i almen praksis</h3>
<ul>
    <li>Ultralyd viser &oslash;get collum-kapsel-afstand som tegn p&aring; &oslash;get ledv&aelig;ske</li>
    <li>R&oslash;ntgen af hofter er normale</li>
    <li>CRP b&oslash;r tages for at udelukke septisk artritis</li>
</ul>
<h3>Andre unders&oslash;gelser hos specialist</h3>
<ul>
    <li>Ved mistanke om septisk artritis, evt. ledpunktur</li>
</ul>
<h3>Tjekliste ved unders&oslash;gelse</h3>
<ul>
    <li><strong>Sygehistorie</strong>
    <ul>
        <li>Debut - n&aring;r og hvordan? Traume? Overbelastning? Forudg&aring;ende infektion? Udvikling/progression?</li>
        <li>Beskriv lidelsen. Lokalisering? Feber? Generel sygdomsf&oslash;lelse? Smerter? Hvilesmerter? Natlige smerter? Startsmerter? Gangproblemer?</li>
        <li>Andre sygdomme af relevans?</li>
        <li>Faste medikamenter?</li>
    </ul>
    </li>
    <li><strong>Kliniske fund</strong>
    <ul>
        <li>Almentilstand? Feber?</li>
        <li>Beskriv barnets halten. Fejlstilling i hoften? Test passiv og aktiv bev&aelig;gelighed i hofteleddet - indskr&aelig;nkninger?</li>
    </ul>
    </li>
    <li><strong>Supplerende unders&oslash;gelser</strong>
    <ul>
        <li>Hb, SR, CRP, leukocytter</li>
        <li>R&oslash;ntgenfund? Ultralyd - &oslash;get ledv&aelig;ske? Andre unders&oslash;gelser?</li>
    </ul>
    </li>
</ul>
<h3>Differentialdiagnoser</h3>
<ul>
    <li>Traume</li>
    <li><a href="~/link.aspx?_id=E666CD5F2753479CA957375F16C73E2D&amp;_z=z">Calv&eacute;-Legg-Perthes sygdom</a>
    <ul>
        <li>Oftest et mere snigende forl&oslash;b</li>
    </ul>
    </li>
    <li><a href="~/link.aspx?_id=4229C2A984A84E1B8CD5EF2234A87941&amp;_z=z">Juvenil reumatoid artritis</a>
    <ul>
        <li>Mere kronisk forl&oslash;b (&gt; 4-6 ugers varighed)</li>
    </ul>
    </li>
    <li><a href="~/link.aspx?_id=92496EEEB72A4D9C927249BFC8D19644&amp;_z=z">Reaktiv artritis</a>&nbsp;(med anden specifik &aring;rsag)</li>
    <li><a href="~/link.aspx?_id=540857B1EC2543868083708EB88B94BF&amp;_z=z">Septisk artritis</a>&nbsp;(p&aring;virket almentilstand)</li>
    <li>Tuberkul&oslash;s artritis (meget sj&aelig;lden)</li>
    <li><a href="~/link.aspx?_id=B3A398199D0146ED8B5184C8BC3A21F9&amp;_z=z">Osteomyelitis</a></li>
    <li><a href="~/link.aspx?_id=FA20E8F143554B13A526A5BFE9F103C3&amp;_z=z">Epifysiolyse</a>&nbsp;(oftest i puberteten)</li>
    <li>Malign sygdom (r&oslash;ntgenfund, andre till&aelig;gsfund)</li>
</ul>
<h2>Behandling<a href=" " data-type="book-reference" data-value="Nigrovic PA. Approach to hip pain in childhood. www.uptodate.com: Wolters Kluwer; 2021" data-value-piped="Nigrovic PA|Approach to hip pain in childhood|www.uptodate.com|Wolters Kluwer|2021" data-url="reference-link" title="Nigrovic PA. Approach to hip pain in childhood. www.uptodate.com: Wolters Kluwer; 2021">1</a><sup>,</sup><a href=" " data-type="journal-reference" data-value="Cook PC, Transient synovitis, septic hip, and Legg-Calvé-Perthes disease: an approach to the correct diagnosis.. Pediatr Clin North Am 2014;61: 1109-18" data-value-piped="Cook PC|Transient synovitis, septic hip, and Legg-Calvé-Perthes disease: an approach to the correct diagnosis.|Pediatr Clin North Am|2014|61|1109-18|25439014" data-url="reference-link" data-pubmedid="25439014" title="Cook PC, Transient synovitis, septic hip, and Legg-Calvé-Perthes disease: an approach to the correct diagnosis.. Pediatr Clin North Am 2014;61: 1109-18">2</a></h2>
<h3>Behandlingsm&aring;l</h3>
<ul>
    <li>Smertelindring og reducere bekymring om diagnose</li>
</ul>
<h3>Generelt om behandlingen</h3>
<ul>
    <li>Behandling er konservativ&nbsp;</li>
    <li>Barnet bliver som regel hurtigt rask uden specifik behandling</li>
    <li>Aflastning og smertestillende behandling</li>
</ul>
<h3>R&aring;d til patienten</h3>
<ul>
    <li>Barnet undlader oftest spontant smertefuld og uheldig belastning og regulerer selv n&oslash;dvendig aflastning</li>
</ul>
<h3>Medicinsk behandling</h3>
<ul>
    <li>Paracetamol og&nbsp;<a href="http://pro.medicin.dk/Laegemiddelgrupper/grupper/213010">NSAID</a>&nbsp;er relevant, hvis der er behov for at lindre smerter og ubehag
    <ul>
        <li>Paracetamol 10-15 mg/kg (max 1 g) og max x 4 dgl, sv.t hver 6 time</li>
        <li>Evt. suppleret med [DliActiveSubstance;6367;ibuprofen] tbl.
        <ul>
            <li>V&aelig;gt 10 - 20 kg: 100 mg x 3 dgl.</li>
            <li>V&aelig;gt 20 - 40 kg: 200 mg x 3 dgl</li>
        </ul>
        </li>
    </ul>
    </li>
</ul>
<h3>Anden behandling</h3>
<ul>
    <li>Ingen kendt</li>
</ul>
<h3>Forebyggende behandling</h3>
<ul>
    <li>Ingen kendt</li>
</ul>
<h2>Henvisning</h2>
<ul>
    <li>Ved udtalte smerter, belastningsv&aelig;gring</li>
    <li>Ved feber, nedsat almentilstand</li>
    <li>Ved klinisk mistanke om septisk artritis, eller hvor dette ikke kan udelukkes</li>
</ul>
<h2>Opf&oslash;lgning</h2>
<h3>Plan</h3>
<ul>
    <li>Anbefales en klinisk kontrol, evt. anden form for tilbagemelding, efter ca. 2 uger</li>
</ul>
<h3>Hvad b&oslash;r man kontrollere</h3>
<ul>
    <li>Fuld restitution med tilbagegang af alle kliniske symptomer</li>
</ul>
<h2>Sygdomsforl&oslash;b, komplikationer og prognose<a href=" " data-type="book-reference" data-value="Nigrovic PA. Approach to hip pain in childhood. www.uptodate.com: Wolters Kluwer; 2021" data-value-piped="Nigrovic PA|Approach to hip pain in childhood|www.uptodate.com|Wolters Kluwer|2021" data-url="reference-link" title="Nigrovic PA. Approach to hip pain in childhood. www.uptodate.com: Wolters Kluwer; 2021">1</a><sup>,</sup><a href=" " data-type="journal-reference" data-value="Cook PC, Transient synovitis, septic hip, and Legg-Calvé-Perthes disease: an approach to the correct diagnosis.. Pediatr Clin North Am 2014;61: 1109-18" data-value-piped="Cook PC|Transient synovitis, septic hip, and Legg-Calvé-Perthes disease: an approach to the correct diagnosis.|Pediatr Clin North Am|2014|61|1109-18|25439014" data-url="reference-link" data-pubmedid="25439014" title="Cook PC, Transient synovitis, septic hip, and Legg-Calvé-Perthes disease: an approach to the correct diagnosis.. Pediatr Clin North Am 2014;61: 1109-18">2</a></h2>
<h3>Sygdomsforl&oslash;b</h3>
<ul>
    <li>Almindeligvis spontan tilbagegang af symptomer i l&oslash;bet af 3-6 dage</li>
    <li>Fuld tilbagegang af symptomerne sker i l&oslash;bet af f&aring; til max. 6 uger</li>
    <li>Ved persisterende symptomer skal overvejes differentialdiagnoser</li>
</ul>
<h3>Komplikationer</h3>
<ul>
    <li>Normalt ingen, fuld restitution</li>
</ul>
<h3>Prognose</h3>
<ul>
    <li>God, fuld restitution hos &gt; 99 %. 4-15 % f&aring;r recidiv, som der ogs&aring; er en god prognose for</li>
    <li>I flere opg&oslash;relser kan 1 % med ser&oslash;s coxitis efterf&oslash;lges af&nbsp;Calv&eacute; Perthe i samme side efter et stykke tid</li>
</ul>
<h2>Baggrundsoplysninger</h2>
<h3>Definition</h3>
<ul>
    <li>Forbig&aring;ende synovitis i hofteleddet, klinisk karakteriseret ved smerte, halten og nedsat bev&aelig;gelighed uden specifik &aring;rsag. Bliver ogs&aring; kaldt coxitis simplex eller ser&oslash;s coxit(is)</li>
</ul>
<h3>Forekomst<a href=" " data-type="book-reference" data-value="Nigrovic PA. Approach to hip pain in childhood. www.uptodate.com: Wolters Kluwer; 2021" data-value-piped="Nigrovic PA|Approach to hip pain in childhood|www.uptodate.com|Wolters Kluwer|2021" data-url="reference-link" title="Nigrovic PA. Approach to hip pain in childhood. www.uptodate.com: Wolters Kluwer; 2021">1</a><sup>,</sup><a href=" " data-type="journal-reference" data-value="Cook PC, Transient synovitis, septic hip, and Legg-Calvé-Perthes disease: an approach to the correct diagnosis.. Pediatr Clin North Am 2014;61: 1109-18" data-value-piped="Cook PC|Transient synovitis, septic hip, and Legg-Calvé-Perthes disease: an approach to the correct diagnosis.|Pediatr Clin North Am|2014|61|1109-18|25439014" data-url="reference-link" data-pubmedid="25439014" title="Cook PC, Transient synovitis, septic hip, and Legg-Calvé-Perthes disease: an approach to the correct diagnosis.. Pediatr Clin North Am 2014;61: 1109-18">2</a></h3>
<ul>
    <li>Den hyppigste &aring;rsag til hoftesymptomer hos b&oslash;rn</li>
    <li>Dreng/Pige ratio: 2/1 </li>
    <li>Hyppigst i alderen 3-8 &aring;r, i gennemsnit 6 &aring;r</li>
</ul>
<h3>&AElig;tiologi og patogenese<a href=" " data-type="book-reference" data-value="Nigrovic PA. Approach to hip pain in childhood. www.uptodate.com: Wolters Kluwer; 2021" data-value-piped="Nigrovic PA|Approach to hip pain in childhood|www.uptodate.com|Wolters Kluwer|2021" data-url="reference-link" title="Nigrovic PA. Approach to hip pain in childhood. www.uptodate.com: Wolters Kluwer; 2021">1</a><sup>,</sup><a href=" " data-type="journal-reference" data-value="Cook PC, Transient synovitis, septic hip, and Legg-Calvé-Perthes disease: an approach to the correct diagnosis.. Pediatr Clin North Am 2014;61: 1109-18" data-value-piped="Cook PC|Transient synovitis, septic hip, and Legg-Calvé-Perthes disease: an approach to the correct diagnosis.|Pediatr Clin North Am|2014|61|1109-18|25439014" data-url="reference-link" data-pubmedid="25439014" title="Cook PC, Transient synovitis, septic hip, and Legg-Calvé-Perthes disease: an approach to the correct diagnosis.. Pediatr Clin North Am 2014;61: 1109-18">2</a></h3>
<ul>
    <li>Ukendt &aring;rsag, men f&oslash;lgende er plausible forklaringer
    <ul>
        <li>Kan v&aelig;re en immunologisk reaktion, da op mod 50 % nyligt har haft en &oslash;vre luftvejsinfektion </li>
        <li>Kan v&aelig;re traumeinduceret, men kun 20-30 % har haft et ad&aelig;kvat traume</li>
        <li>Kan v&aelig;re allergisk betinget</li>
    </ul>
    </li>
</ul>
<h3>ICPC-2</h3>
<p>[ICPC]</p>
<h3>ICD-10/SKS-koder</h3>
<p>[ICD10]</p>
<h2>Patientinformation</h2>
<h3>Link til patientinformation</h3>
<ul>
    <li><a href="~/link.aspx?_id=E4AF7D1A9D80464784B1D41762D48816&amp;_z=z">Information om ser&oslash;s coxitis</a></li>
</ul>
<h2>Link til vejledninger</h2>
<ul>
    <li>Forl&oslash;bsbeskrivelser og regionale pakkeforl&oslash;b [ICPC]&nbsp;</li>
</ul>
<h2>Illustrationer</h2>
<h3>Billeder</h3>
<ul>
    <li>
    <a href="~/link.aspx?_id=6AF0F30758CB417FB2975C0148E34C76&amp;_z=z">Rtg hofte, normale fund (voksen)</a> </li>
</ul>
<h3>Plancher eller tegninger</h3>
<ul>
    <li>
    <a href="~/link.aspx?_id=D151452AD9C44077B47216B963126570&amp;_z=z">Normal hofte, tegning</a></li>
</ul>]]></HtmlField>
      <HtmlField Name="Resume"><![CDATA[<h2>Resum&eacute;</h2>
<h3>Diagnose</h3>
<ul>
    <li>Forbig&aring;ende synovitis i hofteled - Coxitis simplex</li>
    <li>Der er tale om en udelukkelsesdiagnose</li>
    <li>Klinisk og p&aring; baggrund af anamnese</li>
    <li>Ultralydskanning kan verificere ansamling</li>
</ul>
<h3>Behandling</h3>
<ul>
    <li>Symptomatisk med smertestillende medicin</li>
    <li>Aflastning og belastning til smertegr&aelig;nse</li>
</ul>
<h3>Henvisning</h3>
<ul>
    <li>Udtalte smerter, febrilia, almen p&aring;virkning, mistanke om knoglesygdom eller -brud, l&aelig;ngerevarende symptomer</li>
</ul>]]></HtmlField>
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