Septic Arthritis

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  • Rapid diagnosis is imperative because increased pressure within joint may lead to decreased blood supply to the femoral head
  • The majority of the children are less than four years of age. Present with acute onset of fever, pain, ill appearance, refusal to stand, limp. Infants may present with irritability and poor feeding.
  • Hip usually held in flexed and abducted position.
  • Diagnosis is by combination of suspicion, physical findings, radiographic changes with widening of joint space, and obtaining fluid from a joint tap. 
  • Treatment.- Surgical drainage and antibiotics to cover susceptible S. aureus. Further treatment determined by the organisms isolated and their sensitivity to antibiotics.
  • A nearby pelvic osteomyelitis or a psoas abscess may mimic a septic hip. Other possible conditions are: pelvic abscess, septic sacroiliac joint, appendicitis or some gynecologic conditions. Therefore infections of other joints need to be excluded.

(10, 21)

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