Difference between revisions of "Septic arthritis of the hip (peds)"

(Text replacement - "UTZ" to "ultrasound")
(Evaluation)
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#Fever
 
#Fever
  
*1/4 criteria met --> 3% have septic joint
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{| {{table}}
*2/4 --> 40%
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| align="center" style="background:#f0f0f0;"|'''Number of Kocher Criteria'''
*3/4 --> 93%
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| align="center" style="background:#f0f0f0;"|'''Chance of Septic Joint'''
*4/4 --> 99%
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|-
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| 1||3%
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|-
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| 2||40%
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|-
 +
| 3||93%
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|-
 +
| 4||99%
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|}
  
 
==Management==
 
==Management==

Revision as of 21:10, 23 January 2017

Background

Clinical Features

  • Age - 6 mo to 8 yrs
  • Pain, Pseudoparalysis
  • May present with referred knee or thigh pain
  • Usually hold joint in flexion, external rotation and slight abduction

Differential Diagnosis

Pediatric hip pain

Evaluation

Workup

  • Labs - ESR > 20 after 1-2 d, WBC >
  • Bld Cxs (40-50% grow out)
  • Xrays
    • useful to exclude other cause of joint pain (AP & Frog leg)
    • possible effusion
  • CT
    • may be useful to look for abscess, ultrasound for effusion

Evaluation

Kocher Criteria

  1. ESR > 40
  2. WBC > 12
  3. Refusal or inability to weight bear on affected joint
  4. Fever
Number of Kocher Criteria Chance of Septic Joint
1 3%
2 40%
3 93%
4 99%

Management

Disposition

  • Admission

External Links

See Also