EDITOR—A few issues arise from Humes and Simpson's review of acute appendicitis.1 It is important to clinically assess the right groin and hip, particularly in paediatric patients as transient synovitis or irritable hip and septic arthritis are common2 and are differential diagnoses that must be considered for atypical presentations. Children are often referred with abdominal pain where the gait of the patient has not been assessed and a painful limp can often …