InfectionAny age
Pediatric Septic Arthritis
A bacterial infection of a joint that is a surgical emergency, most commonly affecting the hip or knee, with chondral damage risk.
Presentation
- Fever, refusal to bear weight, pseudoparalysis of the limb
- Hip held in flexion, abduction, external rotation
Imaging & Workup
- Ultrasound detects effusion; aspiration is diagnostic
- Kocher criteria help distinguish from transient synovitis
Treatment
Urgent I&D
Surgical drainage of the joint.
IV antibiotics
Empiric coverage including S. aureus, then tailored to cultures.
Clinical Pearls
- Kocher: fever, non-weight-bearing, ESR > 40, WBC > 12k
- Consider Kingella kingae in young children