We need you! Join our contributor community and become a WikEM editor through our open and transparent promotion process.
Pediatric hip pain
From WikEM
Contents
Background
- It can be difficult to differentiate hip from knee pain in children
Clinical Features
Differential Diagnosis
Pediatric hip pain
- Septic arthritis of the hip (peds)
- Slipped capital femoral epiphysis
- Legg-Calve-Perthes disease
- Transient (toxic) synovitis
- Acute rheumatic fever
- Juvenile idiopathic arthritis
- Developmental dysplasia of hip
- Femur fracture
Evaluation
- X-ray hip (AP & Frog leg), knee
- Consider CBC, ESR
- Consider:
- Ultrasound to evaluate for effusion
- CT to evaluate for abscess
Kocher Criteria for septic arthritis of the hip
- ESR > 40
- WBC > 12
- Refusal or inability to weight bear on affected joint
- Fever
| Number of Kocher Criteria | Chance of Septic Joint |
| 1 | 3% |
| 2 | 40% |
| 3 | 93% |
| 4 | 99% |
