Septic arthritis of the hip (peds)
- 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.
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
- 1/4 criteria met --> 3% have septic joint
- 2/4 --> 40%
- 3/4 --> 93%
- 4/4 --> 99%
- Oxacillin, Nafcillin or Clinda in pen all
- cover H. inf as needed w/ 3rd gen ceph.
- IV abx for 10-14 days before po