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

 
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==Clinical Features==
 
==Clinical Features==
*Pain, Pseudoparalysis
+
*[[Hip pain (peds)|Pain]], pseudoparalysis
 
*May present with referred knee or thigh pain
 
*May present with referred knee or thigh pain
 
*Usually hold joint in flexion, external rotation and slight abduction
 
*Usually hold joint in flexion, external rotation and slight abduction
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**possible effusion
 
**possible effusion
 
*Consider:
 
*Consider:
**Ultrasound to evaluate for effusion
+
**[[musculoskeletal ultrasound|Ultrasound]] to evaluate for effusion
**CT to evaluate for abscess
+
**CT to evaluate for [[abscess]]
  
 
{{Kocher criteria}}
 
{{Kocher criteria}}
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[[Category:Pediatrics]]
 
[[Category:Pediatrics]]
 
[[Category:Orthopedics]]
 
[[Category:Orthopedics]]
 +
[[Category:ID]]

Latest revision as of 20:34, 6 October 2019

Background

Clinical Features

  • 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, WBC >12
  • Blood cultures (40-50% grow out)
  • Xrays
    • useful to exclude other cause of joint pain (AP & Frog leg)
    • possible effusion
  • Consider:

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

  • Admit

External Links

See Also

References