avatar

Pediatric Septic Arthritis (Deep Dive R14 MW)

EM Clerkship
EM Clerkship
Episode • Nov 15, 2023




* Differential



* Traumatic causes: non-accidental trauma, fracture, dislocation, sprain, strain, tendonitis, osgood schlatter







* Non-traumatic causes: septic arthritis, transient synovitis, osteomyelitis, SCFE, LCP disease, rheumatologic disease, bony tumors











* Work-up



* XRay







* Labs to evaluate for septic arthritis – CBC BMP ESR CRP











* Kocher Criteria



* Non-weight bearing







* Fever >38.5C







* ESR >40







* WBC >12











* Kocher Criteria Statistics



* 0 points: 0.2% (or 2% in prospective studies)







* 1 point: 3% (or 9% in prospective studies)







* 2 points: 40%







* 3 points:93%







* 4 points: 99%











* Septic Arthritis DX



* >50,000 WBC



* Age 0-3mo : group B strep







* Age 3mo – 12 years: Staph Aureus







* Age 12-18 years: Gonorrhea







* Sickle Cell Disease: Salmonella