Septic arthritis (Pediatric)

Introduction

Define/describe the condition

Anatomy

Describe the pertinent anatomy and provide links to relevant pages

Pathogeneis

Describe the biologic basis of the disorder or the mechanism of injury

Natural History

May cause permanent cartilage damage if untreated within 8 hours.

Patient History and Physical Findings

Describe the means to elicit the most useful information from the patient history and physical examination as well as the relevant findings

Imaging and Diagnostic Studies

Kocher criteria

Four independent predictors:

  1. history of fever
  2. non-weight bearing
  3. erythrocyte sedimentation rate > 40mm/hr
  4. serum WBC count >12,000 cells/cubic mm

Number of predictors

Sensitivity

False-Positive Rate

Probability of Septic Arthritis

No predictors

 

 

2.0%

At least 1 predictor

1.00

0.74

9.5%

At least 2 predictors

0.90

0.32

35.0%

At least 3 predictors

0.59

0.11

72.8%

At least 4 predictors

0.16

0.01

93.0%

Differential Diagnosis

Toxic synovitis/transient synovitis

Juvenile rheumatoid arthritis

Rheumatic fever

Poststreptococcal reactive arthritis

Treatment

Include:


Medical therapy:


Nonoperative treatment


Operative treatment – include links to pages with detailed surgical techniques


Indications and contraindications

Pearls and Pitfalls

Tips and problems to avoid

Postoperative Care

Include immediate postoperative care and rehabilitation

Outcome

Include functional and prosthetic survivorship data as applicable

Complications

Include overview of complications

References