Septic arthritis of hip Flashcards
Hx
6 yr old male, unable to walk for 3 days due to painful l hip. stopped playing, unwell yesterday, fever and vomiting, no PMHx of note
look/inspect
looks unwell, antalgic gait, redness, swelling, L hip in FABER position [Flexed Abducted Laterally rotated]
feel
tenderness and warmth over lateral aspect of L hip
active movement
painful active ROM
passive movement
painful passive ROM
resisted movement
no pain
other exam findings
pyrexial T38^C
normal BMI
DDx
septic arthritis
transient synovitis [no infective symptoms, no fever]
Perthes disease [no infective symptoms]
why is septic arthritis likely?
acute onset pain, fever, feels unwell, pain limited AROM and PROM L hip
why is transient synovitis unlikely?
with irritable hip, but otherwise well
why is Perthes disease unlikely?
no fever, no redness, no swelling
investigations
bloods xray U/S MRI Joint aspiration
bloods
WCC, ESR, CRP
XRAY
AP and lateral
joint space widening or effusion
U/S
joint effusion/ guide aspirations
