Septic Arthritis of Hip
History of fever, malaise and reluctance to bear weight on his leg
https://doctorlib.info/medical/clinical-practice-emergency-medicine/243.html
What will be your approach to diagnosis?
Assess in line of Septic Arthritis and Osteomyelitis
How to assess a child with hip pain and unwell ?
Child unwell - appetite / sleep / pain / weight bearing or not
Temperature
Resting posture of Hip (FABER )
ROM of hip joint
Also examine LL ,Spine , Chest and Abdomen
Investigations
X-ray of Pelvis AP and ipsilateral hip latera view to r/o fracture and any structural abnormality
USG - shows hip effusion , taping done and c/s
Blood c/s , WBC and ESR
Treatment
Arthrotomy and Pus drainage
remove ellipse of capsule ,allow free drainage
sample sent for c/s
irrigation
Hip Spica
Appropriate Antibiotics -initially broad spectrum antibiotics then adjusting based on c/s report and clinical response.
Serial Inlfammatory markers evaluation
Longer follow up for growth and development of acetabulum
Predictive Markers for Hip sepsis
temperature > 38.5 degree celcius
WBC > 12,000 cells/ mm3
ESR > 40
Non-weight bearing
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