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

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==See Also==
 
==See Also==
 
[[Hip Pain]]
 
[[Hip Pain]]
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[[Septic Arthritis (Peds)]]
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[[Category:Peds]]
 
[[Category:Peds]]
 
[[Category:Ortho]]
 
[[Category:Ortho]]

Revision as of 18:51, 14 July 2011

Background

  • hematogenous spread or local inf.
  • wt. bearing joints most common
  • knee (40-50%)
  • hip (20- 25%)
  • staph, S. Pneumo, group A strep
  • in neonates also Groub B strep % gram neg.

Diagnosis

Age - 6 mo to 8 yrs

Pres - Pain, Pseudoparalysis

Labs - ESR > 20 after 1-2 d, WBC >

Xrays - possible effusion


- may present w/ referred knee or thigh pain

- usually hold jt in flexion, ext rotat & slt abduction.

- get Bld Cxs (40-50% grow out)


- Xrays useful to exclude other cause of joint pain (AP & Frog leg)

- CT may be useful to look for abscess, UTZ for effusion.

Kocher Criteria 1. ESR > 40

2. WBC > 12

3. Refusal or inability to weight bear on affected joint

4. Fever

  • 1/4 criteria met --> 3% have septic joint
  • 2/4 --> 40%
  • 3/4 --> 93%
  • 4/4 --> 99%

Treatment

  1. drainage
  2. Oxacillin, Nafcillin or Clinda in pen all
  3. cover H. inf as needed w/ 3rd gen ceph.
  4. IV abx for 10-14 days before po

See Also

Hip Pain

Septic Arthritis (Peds)