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Child, Refusal to Bear Weight
Findings, next step?
Hip Ultrasound Final Dx,
course of action?

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Septic Hip

  • Initial pelvic film shows widening of the Rt. Hip joint, displacement of the “capsular” and obturator fat planes, and obliteration of the iliopsoas fat plane
  • Hip ultrasound shows a Rt. Hip effusion with internal echoes, consistent with an infected hip
  • Untreated, it will progress to joint/cartilage destruction ± osteomyelitis ->growth disturbance / osteoarthritis long-term
  • Drainage (ortho consult) is the cornerstone to successful treatment; per eMedicine, an 18-ga needle is used (*this was asked once!)



Additional Information

Septic arthritis, common organisms:

Neonates / infants group D streptococcus
< 4 yo H. influ., strep. Pyogenes, S. aureus
>4 yo S.aureus
> 10yo S.aureus, Neisseria gonorrheae
Adults S.aureus

Hematogenous infection is the most common

In adults, think of the five “S” joint: Shoulder, Sternoclavicular, Spine, SI, andSymphysis pubis

In addition to drainage, also give IV antibiotics:
  • oxacillin or nafcillin

  • ceftriaxone, cefotaxime, or ceftizoxime


These signals are relayed buying clomid online safe which then is by a number of such as medial preoptic and paraventricular nulcei.