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

(Text replacement - "==Diagnosis==" to "==Evaluation==")
(Text replacement - "UTZ" to "ultrasound")
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**possible effusion
 
**possible effusion
 
*CT  
 
*CT  
**may be useful to look for abscess, UTZ for effusion
+
**may be useful to look for abscess, ultrasound for effusion
  
 
===Evaluation===
 
===Evaluation===

Revision as of 18:33, 30 July 2016

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

Management

Disposition

  • Admission

External Links

See Also