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

(Evaluation)
(Evaluation)
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**may be useful to look for abscess, ultrasound for effusion
 
**may be useful to look for abscess, ultrasound for effusion
  
===Evaluation===
+
{{Kocher criteria}}
====Kocher Criteria====
 
#ESR > 40
 
#WBC > 12
 
#Refusal or inability to weight bear on affected joint
 
#Fever
 
 
 
{| {{table}}
 
| align="center" style="background:#f0f0f0;"|'''Number of Kocher Criteria'''
 
| align="center" style="background:#f0f0f0;"|'''Chance of Septic Joint'''
 
|-
 
| 1||3%
 
|-
 
| 2||40%
 
|-
 
| 3||93%
 
|-
 
| 4||99%
 
|}
 
  
 
==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

Kocher Criteria for septic arthritis of the hip

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

Management

Disposition

  • Admission

External Links

See Also