Septic arthritis of the hip (peds)

Revision as of 15:59, 22 March 2016 by Ostermayer (talk | contribs) (Text replacement - "Category:Peds" to "Category:Pediatrics")

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

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%

Treatment

Disposition

  • Admission

External Links

See Also