Septic Hip
by
Joseph Davey, MD
Few orthopedic problems elicit as much anxiety in the on-call physician as that of a possible septic hip in a child. The differential diagnosis is extensive and a ruined hip can result if appropriate treatment is delayed. Although it is not rare, the incidence is not known; 50 percent of cases occur in children younger than 3 years of age. The patient history is often critical in diagnosing a septic hip in a child. Joint aspirate and culture is the most critical test in evaluating an irritable hip. Nonsurgical treatment of hip sepsis has two components: serial aspiration and antibiotic treatment.
The pathophysiology and etiology of septic hip in children is reviewed extensively, and nonsurgical and surgical management considerations and options are discussed in detail. Video is available.
Keywords: hip joint, septic arthritis, joint infection, hip infection, septic joint, bacterial arthritis, suppurative arthritis, acute septic arthritis, pyogenic arthritis, gonococcal arthritis, Haemophilus influenzae type b, H influenzae type b, Staphylococcus aureus, S aureus, etiology, microbiology, organisms, diagnosis, patient history, physical examination, laboratory tests, imaging, radiography, ultrasound, MRI, bone scan, scintigraphy, joint aspiration, culture, differential diagnosis, management, nonsurgical treatment, antibiotics, surgical treatment, surgical techniques, arthrotomy, arthroscopy, indications, contraindications, complications
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