View source for Septic arthritis of the hip (peds)

==Background==
{{Hip anatomy background images}}
*Age - 6 mo to 8 yrs
*Hematogenous spread or local infection
*[[Staph]], [[S. Pneumo]], [[group A strep]]
*Neonates: also [[Group B strep]] and [[gram negatives]]

==Clinical Features==
*[[Hip pain (peds)|Pain]], pseudoparalysis
*May present with referred knee or thigh pain
*Usually hold joint in flexion, external rotation and slight abduction

==Differential Diagnosis==
{{Pediatric hip DDX}}

==Evaluation==
===Workup===
*Labs - ESR >20, WBC >12
*Blood cultures (40-50% grow out)
*Xrays 
**useful to exclude other cause of joint pain (AP & Frog leg)
**possible effusion
*Consider:
**[[musculoskeletal ultrasound|Ultrasound]] to evaluate for effusion
**CT to evaluate for [[abscess]]

{{Kocher criteria}}

==Management==
*OR drainage
*IV [[antibiotics]] x 10-14 days (before po)
**[[Oxacillin]], [[Nafcillin]] or [[Clindamycin]] in penicillin allergic
**Cover [[Haemophilus influenzae]] as needed with 3rd generation [[cephalosporin]]

==Disposition==
*Admit

==External Links==
*[http://www.mdcalc.com/kocher-criteria-septic-arthritis/ MDCalc - Kocher Criteria for Septic Arthritis]

==See Also==
*[[Hip Pain (Peds)]]
*[[Septic Arthritis (Peds)]]
*[[Limp (peds)]]

==References==
<references/>

[[Category:Pediatrics]]
[[Category:Orthopedics]]
[[Category:ID]]