Hip pain (peds): Difference between revisions
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*X-ray hip (AP & bilateral Frog leg), femur, knee | *X-ray hip (AP & bilateral Frog leg), femur, knee | ||
*Consider CBC, ESR, | *Consider CBC, ESR, CRP | ||
*Consider: | *Consider: | ||
**[[Ultrasound]] to evaluate for effusion | **[[Ultrasound]] to evaluate for effusion |
Revision as of 19:06, 8 August 2019
This page is for pediatric patients; for adult patients see hip pain
Background
- It can be difficult to differentiate hip from knee pain in children
Clinical Features
- Hip pain
Differential Diagnosis
Pediatric hip pain
- Acute rheumatic fever
- Developmental dysplasia of hip
- Femur fracture
- Juvenile idiopathic arthritis
- Legg-Calve-Perthes disease
- Septic arthritis of the hip (peds)
- Lyme disease arthritis
- Slipped capital femoral epiphysis
- Transient (toxic) synovitis
- Osteosarcoma
Evaluation
Workup
- X-ray hip (AP & bilateral Frog leg), femur, knee
- Consider CBC, ESR, CRP
- Consider:
- Ultrasound to evaluate for effusion
- CT or MRI to evaluate for abscess
Kocher Criteria for septic arthritis of the hip
- ESR > 40 mm/hr
- WBC > 12,000/microliter
- Refusal or inability to weight bear on affected joint
- Fever 38.5° C or greater
Number of Kocher Criteria | Chance of Septic Joint |
1 | 3% |
2 | 40% |
3 | 93% |
4 | 99% |