![]() ![]() You can refer back to your journal to jog your memory or provide recommendations to fellow travelers. By documenting your itineraries, accommodations, transportation details, and recommendations, you create a valuable reference guide that covers your experiences more fully. ![]() Your travel journal can serve as a practical resource for future trips. The process of self-reflection through journaling can lead to personal transformation and a deeper connection to the world. You may discover new passions or interests, challenge preconceived notions, or develop a greater sense of empathy and understanding for others. As you reflect on your experiences, you gain insights into your own values, beliefs, and perspectives. Writing in a travel diary allows for introspection and personal growth. Your journal becomes a testament to the richness and diversity of the world around you. By documenting your interactions with locals, sampling regional cuisine, and exploring hidden gems, you develop a greater appreciation for the unique aspects of each destination. It prompts you to delve deeper into the local culture, traditions, and customs. ![]() Cultural Exploration and AppreciationĪ travel journal encourages you to be more observant and attentive to the details of the places you visit. Your travel diary becomes a valuable tool for preserving and retrieving cherished memories. This makes it easier to recall specific moments, sights, sounds, and even the feelings associated with them in the future. By actively engaging with your experiences and recording them in detail, you reinforce the neural connections related to those memories. ![]() Writing about your travels helps improve memory retention. It can be a therapeutic outlet for releasing stress, anxiety, or even excitement, allowing you to better manage your emotions throughout your journey. When you write about your travel experiences, you have the opportunity to process and reflect on your emotions, helping you gain a deeper understanding of yourself and your reactions to different situations via your journal entries. Journaling has been shown to have positive effects on emotional and mental well-being. Here are some additional reasons why you should consider starting one: 1. Keeping a travel journal offers numerous benefits beyond simply documenting your experiences. Unlike a regular journal, a travel diary focuses specifically on your journeys, including details about the different places you visit, the people you meet, the food you try, and the sights you see. It serves as a visual and written account of your adventures, providing you with a tangible keepsake that you can cherish for years to come. Ready to discover how to capture your travel experiences in different places, explore creative travel journal ideas and travel journal prompts, and more? Let the adventure begin! What is a Travel Journal?Ī travel journal is a personal diary that allows you to record your thoughts, feelings, and experiences during your travels. In this article, we'll cover what a travel journal is, the benefits of keeping one, how to choose the best travel journal among different types, and provide you with tips and examples on how to make your own. One popular and creative way to document your travels is through a travel journal. Whether you're exploring a bustling city, immersing yourself in nature's wonders, or embarking on a cultural adventure, capturing your travel experiences is a great way to preserve memories and reflect on your journey. Traveling to new places and journaling about your exciting and enriching experiences is beyond rewarding. What Is a Travel Journal + How to Make One with Examples ![]()
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![]() ![]() Looking for "hidden pairs" (two numbers that can only go in two specific cells in the same row, column, or box).Looking for "naked pairs" (two cells in the same row, column, or box that contain only the same two numbers as possibilities).If you get stuck, try using the following techniques:.Repeat steps 1-3 until the puzzle is solved, or until you reach a point where you cannot make any more progress using these methods.If a cell can only contain one number, and that number must go in that cell, then all other cells in the same row, column, and box can be eliminated as possibilities for that number. If there is only one cell in a row, column, or box that can hold a specific number, then that cell must contain that number. Look for rows, columns, and 3x3 boxes that contain only one possible cell for a particular number.If a cell can only be filled with one number, then it must be that number. Start by looking for cells that have only one possible value.So, these are the basic rules of sudoku that you need to follow while playing the game. Whether you are a seasoned sudoku player or just starting out, there is always a new puzzle waiting to be solved. It is suitable for players of all ages and can be enjoyed by people of all skill levels, from beginners to experts. Sudoku can be a challenging and rewarding puzzle game that requires critical thinking and problem-solving skills. However, the basic rules and objective of the game remain the same. There are several variations of sudoku, including different grid sizes and the use of letters or symbols instead of numbers. ![]()
![]() ![]() Any messages to individual moderators will be ignored. If you disagree with a moderator's decision to issue a warning or ban, please reach out to us in modmail for appeals. If youre in a non-title-holding state and you simply cant find the title or it got damaged, you can request a duplicate title from your local DMV or SOS, or. This includes things like events that happened in United States, but has no relation to Illinois.įinal offense: Permanent ban (any offense of site-wide rules will immediately result in a permanent ban).Īll bans and warnings are left to moderator discretion. Posts about things outside of Illinois that have no relation to Illinois will be removed. Rule 5: Posts must be related to Illinois. Violating the rule is bannable, even if you have no history of doing it. We will not tolerate hate speech, doxing, or threats. Rule 3: No Discrimination, Harassment, or Malicious Content. Failure to do so will result in removal, and repeated offenses can lead to bans If you are unable to obtain the title, please contact us at 57 or you can Ask Motor Vehicle A signed Application for Missouri Title and License (Form 108) PDF Document. Missouri titles are mailed to the vehicle owner. All discussions, including disagreements, are expected to be carried out civilly. When the Missouri title is issued, the lien will appear on the face of the title. Rule 1: Sitewide rules are in place at all times. Looking for community, sports, university, and other Illinois-themed subreddits? Check out the official /r/Illinois multi-reddit for your one-stop browsing needs. ![]() ![]() ^ " – Keith Jarrett – Bordeaux Concert" (in German).^ "Ultratop.be – Keith Jarrett – Bordeaux Concert" (in French). ![]() ^ "Ultratop.be – Keith Jarrett – Bordeaux Concert" (in Dutch)."Review: Keith Jarrett at his peak on 'Bordeaux Concert' ". "On 'Bourdeaux Concert,' Keith Jarrett Releases Highly Lyrical Third Solo Concert From Acclaimed 2016 Tour". "Keith Jarrett: Bordeaux Concert review – a fearless final performance". ![]() ^ a b Fordham, John (September 30, 2022)."Keith Jarrett says farewell, Björk has a romantic reawakening – the week's best albums". ^ a b Hewett, Ivan (September 30, 2022).^ a b Jurkovic, Mike (September 11, 2022).^ Keith Jarrett 2016 live concerts accessed March 14, 2021.Christoph Stickel – engineer (mastering)Ĭharts Chart performance for Bordeaux Concert Chart (2022).He likes what he's hearing, and it's easy to understand why." One yearning melody unfolds like an invitation to hum, and so Jarrett does. Jim Hynes of Glide Magazine wrote: "Every Jarrett solo performance holds its own magical appeal and Bordeaux certainly holds its own with any of the others in his storied catalog." Īssociated Press writer Steven Wine praised the album's "astounding mix of intensity, introspection and invention," and commented: " Structure and pacing are a marvel as Jarrett's on-the-spot composition swings between gorgeous lyricism and dissonant, distressed chromatic explorations that abandon tempo. In an article for The Daily Telegraph, Ivan Hewett remarked: "If this album turns out to be Jarrett's farewell, it will be a more than worthy one." Just waiting for one to encounter it and come to the greater understanding of just how beautiful, how peaceful, this life can be." In the air, in the heart, in the quiet turnings of a world at large. Mike Jurkovic, writing for All About Jazz, called the album "a remarkable listen," and stated: "Bordeaux Concert feels like it has always been there. The Guardian 's John Fordham noted that "everything from the softest improvised ballads to the most exuberantly hard-stomping blues draw grateful accolades – the sound of an audience's thanks for a one-off music that belonged only to their presence with Jarrett, in that space, on that unique evening." This is not only masterful, it soulful, interrogatory, and virtuosic." The dialogue he engages in with the piano here challenges its own assertions with an unassuming, even reverential authority. In a review for AllMusic, Thom Jurek wrote that the album "is not for the Jarrett beginner, but for seasoned fans of his many solo recordings, that are, after all, responsible for a sizeable portion of his legendary reputation. Reception Professional ratings Review scores July 16 – Philharmonie, Gasteig, Munich, Germany.July 12 – Parco Della Musica, Rome, Italy.July 9 – Goldener Saal, Musikverein, Vienna, Austria.July 6 – L'Auditorium de Bordeaux, Bordeaux, France.July 3 – Béla Bartók National Concert Hall, Palace of Arts, Budapest, Hungary.May 2 – Davies Symphony Hall, San Francisco, California (US).April 29 – Walt Disney Concert Hall, Los Angeles, California (US).February 9 – Isaac Stern Auditorium, Carnegie Hall, New York City (US).Bordeaux Concert was recorded at the fifth of those concerts, on the second night of his European tour. The festival rented the Bordeaux Auditorium for that event.Īccording to, in 2016 Jarrett played a total of 8 solo piano concerts. ![]() ![]() This concert was produced by Jazz And Wine Bordeaux Festival for the opening concert of the 2016 edition and celebrates the 10 anniversary of the festival. It was released by ECM Records on CD in September 2022. L'Auditorium de Bordeaux, Bordeaux, Franceīordeaux Concert is a solo piano album by Keith Jarrett containing music recorded live on July 6, 2016, at L’Auditorium de Bordeaux, Bordeaux, during a European tour. ![]() ![]() The cookie is set by the GDPR Cookie Consent plugin and is used to store whether or not user has consented to the use of cookies. The cookie is used to store the user consent for the cookies in the category "Performance". ![]() This cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Other. ![]() The cookies is used to store the user consent for the cookies in the category "Necessary". The cookie is set by GDPR cookie consent to record the user consent for the cookies in the category "Functional". The cookie is used to store the user consent for the cookies in the category "Analytics". These cookies ensure basic functionalities and security features of the website, anonymously. To print multiple puzzles, there are special pages to print two, four, or six puzzles per page.Necessary cookies are absolutely essential for the website to function properly. Guessing is never required - but it may help! Each puzzle has a unique solution and can be solved with pure logic. The position is saved as 81 digits at the end of the URL string, with hyphens used for empty cells.Įxtreme Sudoku posts five new puzzles every day. With our Daily Sudoku game you can come back every day and challenge yourself with a fresh new puzzle Train your brain with Sudoku and have. This allows you to have a rest and escape from everyday routine. This fun logic puzzle can be played anytime and anywhere. To save any position, right-click on under the grid, and click Add To Favorites or Bookmark This Link. Daily Sudoku may help to relieve stress and calm you down in nervous situations. You can add symbols too, such as question marks. If you prefer to enter your own pencilmarks, up to six digits can be entered in each cell. Please do not use my puzzles in for-profit publications without my permission. Feel free to reproduce the puzzles for personal, church, school, hospital or institutional use. Three-way Binox Also known as Trinox, Threedoku, and Train Snacks. ![]() These update by themselves as you solve particular cells and cannot be edited manually. My original collection has tons of printable Sudoku puzzles. There are automatic pencilmarks that appear if you check the Pencilmarks box. So it's possible to have incorrect digits that don't conflict, but eventually you will get stuck. The Show Conflicts button does not apply the solving logic - just checks whether there are any conflicting digits already in the grid. To print the puzzles use either the Print button below the grid, or if you want to print the pencilmarks as well, use the browser Print option under the File menu. See our guide to solution rules for hard sudoku puzzles.Īll the puzzles on this site rate a "fiendish" category, but then we picked the hardest, and graded them in five progressively more difficult categories: Evil, Excessive, Egregious, Excruciating, and Extreme, in order from least difficult to most difficult. ![]() Difficulty depends on the type of steps required to solve them, and also on the number of each type of step. Solving these puzzles is a different matter entirely, since these are the most difficult puzzles we create. Each row, column, and 3 x 3 box must contain only one of each of the 9 digits. Just place the digits from 1 to 9 in each empty cell. Then try some of our very hard sudoku puzzles. ![]() ![]() ![]() ![]() When the stitching is finished, move the hoop to the next pre-marked section of the quilt, tap the buttons on the machine, and watch it go all over again. (I’m pretty mesmerized watching the perfect stitching that I can’t mess up! lol). Then watch the machine do all of the stitching work. Using the markings as a guide, hoop the area to be quilted and select the pre-programed corresponding tile-size design to fill that space. Mark the area to be quilted according to the size range you want done using one of dozens of different ’tiles’ or guides. No need to pin as the hoop will hold layers securely together when stitching. Spray baste your quilt sandwich layers (top, batting, and backing). You can check out the Kimberbell Clear Blue Tiles videos to see the full process for yourself, but here’s the basic gist: How to Use Clear Blue Tiles for Machine Quilting No need to pull out rulers and re-measure every spot to line-up before moving the hoop. Clear Blue Tiles have been a game changer for me!! They have simplified the process SO MUCH. When they reached out to see if I would be interested in trying out the Clear Blue Tiles system* I was definitely intrigued, but still a little intimidated at the idea of where and how to re-hoop my project for the best look. Can anyone else relate?Ī couple of months ago Kimberbell Designs released their new tool called Clear Blue Tiles to help specifically with machine quilting at home on an embroidery machine. It just felt like one more hurdle, so I kept putting off trying. It felt like it required more thinking and brainpower than I felt capable of. Plus I have a machine that can do the work for me – I just needed to learn how to be effective using that tool! So I’ll confess what held me back: feeling overwhelmed about the idea of how to place and line-up the quilting designs within the quilt itself. My free-motion quilting skills are the pits. It’s such a great feature of embroidery machines – especially ones that come with the large hoop size – and I knew my Baby Lock Destiny was very capable of doing it. One of my biggest motivations for doing this was to learn how to use the quilting-in-the-hoop function so that I could quilt projects on my machine at home. I recently shared my goal this year of learning how to better utilize my Baby Lock embroidery machine. ![]() ![]() We were serving gorditas and huaraches and pescada veracruzana and Yucatán pork, things that were very traditional but you didn’t see in LA back then.”īeing a chef for several restaurants was not only a passion but it seemed to be her destiny. ![]() We had spent a lot of time in Oaxaca and the Yucatán, learning about traditional Mexican regional dishes that we had never seen. We were make homemade tortillas, we were going to Mexico and learning about ingredients we had never seen before. We were doing food and Mexican beers and margaritas, and there wasn’t an upscale Mexican food scene happening on the westside, so we stood out. “Our first Border Grill on Melrose was 31 years ago, so back then there wasn’t a lot happening in terms of restaurants that were doing Mexican, other than taquerias of course. In the 1980s in Los Angeles, there was little gourmet Mexican outside of small taquerias in East Los Angeles, and Border Grill introduced a new type of Mexican cuisine to discerning diners. So Mary Sue and I thought, ‘Cool, let’s do a Border Grill there.’” Back then, we had done consulting for Angel City Brewery in a location that was going out of business, and it became available. “We had this tiny little Border Grill that was nine/ten tables with a tiny, little kitchen. We wrote the menu and opened Border Grill from our first road trip.”īorder Grill was wildly successful and prompted the opening of a larger location in Santa Monica. “Mary Sue and I were deciding what to do with City Cafe, so we tossed a coin between ‘Mexico taco stand’ and ‘Japanese noodle shop.’ Mexico won, so we took a ten-day trip to Mexico, stayed at the home of a kid who worked with us in Mexico City. In fact, Mary Sue and Susan literally flipped a coin. It wasn’t necessarily in her life plan, and it was truly an unsystematic decision. Then we turned the little City Cafe on Melrose into our first Border Grill.”Ĭonsidering Susan’s entire training and experience in French culinary arts, her faithful foodie fan base was surprised when she started serving Mexican. With this success, we thought we should open a bigger restaurant, which we did, now City restaurant, which has Indian, Thai, French, and more. I called Mary Sue and about a year later she came out and worked at City Cafe with me. We got our first gourmet write up for a tiny café. I worked both jobs for six months before I decided I would go there full-time. I had two hibachis in the back parking lot and made food for them. They were doing great espressos but they were buying food from the outside, like sardine sandwiches, so I put a hot plate in there and did soup of the day. “City Cafe was a tiny coffee shop, and I went in every day to help them put a special on the menu. Still working at Ma Maison, a friend was running a small coffee shop where Susan helped design a menu. While French cuisine was her forte, the universe had other plans for her. Truly filled with a passion for French cooking, Susan took a short stint in the French Riviera at then threestarred L’Oasis before moving back to Los Angeles to work again at Ma Maison. It was so star-studded all the tickets were like Paul Newman, Orson Wells, Jane Fonda…the valet guys used to come in and tell me whose car they were parking, it was that star studded.” It was old-school, and Wolfgang was just becoming well known in the industry. “Ma Maison was really the only hip place at the time. The stars aligned for Ma Maison, an infamous, celebrity-packed restaurant helmed by a young Wolfgang Puck. At the time, there were four fabulous French restaurants she wanted to work at: Ma Maison, La Toque, L’Orangerie, and L’Ermitage. ![]() In 1978, Susan packed her bags for Los Angeles. “There were definitely walls up that were hard to climb over, but there were so many people ‘out’ in our industry that when you were in it, you didn’t feel pressure because of that.” ![]() “I worked really hard, and women in French restaurants back in the 1970s had to be strong,” she says. While she’s proven to serve up innovative and unforgettable Mexican fare, her career wasn’t planned this way considering her background in French cuisine.Ĭlassically trained at the Culinary Institute of America, Feniger landed a job at Chicago’s famed Le Perroquet in 1977 as one of the first females in the all-male kitchen. Celebrated chef, author, and entrepreneur, Susan Feniger has become legendary in Los Angeles for her award-winning restaurants CITY, Mud Hen Tavern, Blue Window, and Border Grill, her most well-known restaurant that she has operated for 35 years with business partner Mary Sue Milliken in four locations: Downtown LA, LAX International Airport, and two in Las Vegas. ![]() ![]() ![]() If you changed your address with the USPS, but your mail is still missing, you need to verify that the request went through. If you don’t file a change-of-address request, your mail will continue to arrive at your old address – so you won’t be getting it after the move. (See also: How to change your address when moving) Once your request is processed, your mail will be redirected to your new address. Fortunately, it’s fast and easy to complete – all you have to do is fill out a change-of-address (COA) form, either online or at your local post office. Make sure you changed your address with the USPSĬhanging your address is one of the many important tasks you need to take care of when moving to a new place. Read on to find out what to do if you’re not receiving mail after moving. What can you do then? How to get your mail and prevent further problems? But if all your mail is missing after the move, then something is clearly wrong – most probably, your mail is still going to your old address. Well, the USPS handles millions of mail pieces every day, so it’s easily possible for a letter or package to get lost. ![]() ![]() Why could that be happening? What could be the reason for not getting mail after moving? It’s been a week or so after the move and you haven’t received a single letter or package at your new address. You have unpacked your items and set up your new place, met the neighbors and explored your new surroundings – everything is as it should be.Įxcept you get no mail. So, your move is finally over and you’re ready to start your new life in your new home. ![]() ![]() ![]() I should point out that the previous owner of the Ranger X manual took the liberty of underlining every ''the'' they could find in the manual. If you did not know, this has hands down the best graphics on the Genesis console, next to Alien Soldier. My most recent pick-up, I found this yesterday complete with instructions for a hilarious $4. This game is not (it's pure action oriented YEEHAW), but it feels like a musical with some of the most brilliant tracks ever heard in a game. Especially for you guys who are into music oriented games. This is universally regarded as one of the most underrated Genesis game of its time by reviewers on the net. Look it up too! You'll either love it or hate it!īaBAM! When I wasn't playing Atomic Runner, this is what I was playing. Or just average, but those games are boring. I like the fact that the developpers always have to play around the limitation of the hardware, everything on that console is either better than the SNES or worse than the NES. ![]() My top 5 games as of December 2011! Even though I have a lot more NES games than anything, I really am more of a Genesis guy (don't let the username fool you!). My most valuable game (in 2011), look it up! (Cheapest copy on ebay is $156 and doesn't include the artwork lawl) Those of you who are 2D shooter fans are in for a match in heaven. Don't worry, there's a lot of stuff hiding behind that NES cartridge wall (expensive wall) Virtua Cop 2 with light gun (Sega Saturn) Gauntlet IV (GEN), if only for the music, I still cannot believe my hears.Įternal Champions: Challenge from the Dark Side (Sega CD) ~~Wishlist~~ (If you ever have any of these games and are willing to send them my way. PlayStation 1 (all are DBM if not stated otherwise):įinal Fantasy VII Greatest Hits (no manual) Sega Saturn (all are DBM if not stated otherwise): ![]() Superman 64 donated by Hateandhatred, a huge THANK YOU! ![]() The Legend of Zelda: A Link to the Past (CMB) Teenage Mutant Ninja Turtles IV: Turtles in Time Street Fighter II (C) donated by Hateandhatred, a huge THANK YOU! Super Mario RPG Legend of the Seven Stars (C) Super Mario All-Stars + Super Mario World (C) Shaq Fu (C) donated by Hateandhatred, a huge THANK YOU! Mario Is Missing (C 2x) one of them donated by Hateandhatred, a huge THANK YOU! The Simpsons Bart VS The Space Mutants (CMB) Street Fighter II: Special Champion Edition (CB) Shinobi III: Return of the Ninja Master (C) Shaq-Fu (C 2x) one of them donated by Hateandhatred, a huge THANK YOU! Lightening Force (CMB) (AKA Thunder Force IV) SEGA Master System (this console along with 2 controllers were donated by Hateandhatred during my trip to his place in January 2014. Track & Field (C) <- good jack practice for people interested Teenage Mutant Ninja Turtles: The Arcade Game (C) Recca (CMB) (reproduction, but check this game out it's so awesome) Milon's Secret Castle (C x2) both donated by Hateandhatred, a huge THANK YOU! Gyromite (C) donated by Hateandhatred, a huge THANK YOU! The Flintstones: The Rescue of Dino and Hoppy (C) Jekyll and My Hyde (C) donated by Hateandhatred, a huge THANK YOU!ĭream Mary/Mario Invisible (CB) (Pirate cartridge, but very cool)įester's Quest (C) donated by Hateandhatred, a huge THANK YOU! The Extraterrestrial (C) donated by Hateandhatred, a huge THANK FUCK YOU!ĭonkey Kong (C) donated by Hateandhatred, a huge THANK YOU!Ĭalifornia Games (C) Donated by T-Force, a huge THANK YOU!Ĭastlevania II: Simon's Quest (C) donated by Hateandhatred, a huge THANK YOU!Ĭheetahmen II: The Lost Levels (CMB) (it's the Greg Pabich Kickstarter thingy)ĭouble Dragon (C) donated by T-Force, a huge THANK YOU!ĭr. I did not post pictures, but if someone wants me to I could, lulĮ.T. in fact, I don't even own that console yet (not anymore!!). :3 This is still a WIP so don't kick me if I don't have games like Super Mario 64. I know that some of you guys are into collecting games, I thought I'd post the games I have so far so that we can compare. I've always wanted to make some kind of list of the retro games I currently own. ![]() ![]() ![]() Hence clinical context and other diagnostic tests would be necessary to distinguish one from another. Presence of hip effusion cannot distinguish between a benign condition (eg, transient synovitis) and a more serious condition (eg, septic joint, osteomyelitis).Effusion can sometimes be heterogeneous or even hyperechoic, especially with purulent material.However, 46-86% of patients with transient synovitis of the hip also have effusion present.Treatment is intravenous antibiotics +/- open joint irrigation.Septic arthritis may progress to destruction of cartilage and bone if untreated, leading to permanent disability.POCUS can also be used to guide diagnostic arthrocentesis.Hip without effusion (left) has a concave shaped joint capsule and hip with joint effusion (right) has a convex shaped joint capsule. Joint capsule also appears convex instead of concave in case of effusion.Capsular-synovial thickness measurement >5mm in hip effusion (right) A capsular-synovial thickness >5 mm, or >2 mm difference compared to the asymptomatic contralateral side indicates hip joint effusion in children.Measure thickness of joint (area from periosteum to outer joint capsule just deep to iliopsoas muscle) at the femoral neck.Anatomy of hip joint on ultrasound (C: Cartilage/physis on femoral head, FH: Femoral Head, FN: Femoral Neck, JC: Joint Capsule, IP: Iliopsoas muscle) Identify the hyperechoic fibrous joint capsule. Use femoral head and the slanting neck as landmark.Locate the femur with its characteristic hyperechoic periosteum and posterior acoustic shadowing. ![]() Placement of ultrasound transducer (a) and X-ray of the hip (b) Place transducer on anterior hip, along the long axis of the femoral neck, slightly below and perpendicular to inguinal ligament and lateral to the femoral vessels.Hips in slight external rotation and flexion (“frog-leg” position), if possible. Lower frequency, curvilinear transducer may be necessary in patients with thicker soft tissue layers. Typically a high frequency (5-10MHz), linear transducer is used due to superficial location of structures.Scanning Technique, Normal Findings and Common Variants Iliopsoas muscle lies anterior/superficial to the joint capsule.Hip joint is where the head of femur articulates with the acetabulum of the pelvis.Additional case series have also been published of emergency physicians using POCUS to facilitate evaluation of pediatric hip pain.A retrospective study by the same group on 516 patients (926 hips) reported POCUS sensitivity of 85% and specificity of 98%, with overall accuracy of 93%.In a prospective study of 28 patients (55 hips), Vieira and Levy found that emergency physician performed point-of-care ultrasound (POCUS) was 80% sensitive and 98% specific in detecting hip effusions compared to the gold standard of radiology department ultrasound.Ultrasound can detect effusion as small as 1mL, with sensitivity of 90-100%.Presence of a hip effusion may raise suspicion for septic arthritis, osteomyelitis, and other time sensitive diagnoses while absence of effusion may decrease need for further testing.Along with X-ray and blood tests, ultrasound is a valuable tool to narrow down differential diagnosis.Differential diagnosis includes septic arthritis, transient synovitis (toxic synovitis), osteomyelitis, neoplasm, Legg-Calve-Perthes disease, avascular necrosis of femoral head, fracture, muscle strain, and juvenile rheumatoid arthritis among others.Hip pain/limping are common complaints in children presenting to the ED. ![]() |
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