Clinical Prediction Algorithm for Septic Arthritis
Matthew G. Gartland
Chadi M. El Saleeby
Differentiating Between Septic Arthritis and Transient Synovitis of the Hip in Children: An Evidence-Based Clinical Prediction Algorithm
Kocher MS, Zurakowski D, Kasser JR. J Bone Joint Surg Am. 1999;81(12):1662–1670
Background
With delay in diagnosis, septic arthritis (SA) in children may be complicated by joint restriction, bone necrosis, and pathologic fractures. Early diagnosis, however, remains a challenge as there are many benign mimicking conditions. This study sought to establish a simple algorithm to distinguish between 2 common but therapeutically disparate pathologies: SA and transient synovitis (TS).
Objectives
To develop an evidence-based clinical algorithm to differentiate between SA and TS of the hip in ambulatory children.
Methods
Retrospective cohort study in a single US center from 1979 to 1996.
Patients
168 children (mean age 5.6 years) with acute hip pain presenting to the emergency department. Select exclusion criteria: underlying immunocompromise, rheumatologic disease, adjacent osteomyelitis, fracture or other anatomical abnormalities on x-ray, or no CBC or adequate joint fluid evaluation performed.
Intervention
General demographic and clinical data were extracted from medical records: fever, recent infection and antibiotic use, weight-bearing status, erythrocyte sedimentation rate (ESR), serum white blood cell count (WBC), and radiographic findings.
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
