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

(Treatment)
Line 37: Line 37:
 
==Treatment==
 
==Treatment==
 
* OR drainage
 
* OR drainage
* IV [[antibioticis]] x 10-14 days (before po)
+
* IV [[antibiotics]] x 10-14 days (before po)
 
**[[Oxacillin]], [[Nafcillin]] or [[Clindamycin]] in penicillin allergic
 
**[[Oxacillin]], [[Nafcillin]] or [[Clindamycin]] in penicillin allergic
 
** Cover [[H. inf]] as needed with 3rd generation [[cephalosporin]]
 
** Cover [[H. inf]] as needed with 3rd generation [[cephalosporin]]

Revision as of 04:13, 7 June 2015

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

Diagnosis

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, UTZ for effusion

Kocher Criteria

  • ESR > 40
  • WBC > 12
  • Refusal or inability to weight bear on affected joint
  • Fever


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

Treatment

External Links

See Also