Problems in the diagnosis of pediatric septic arthritis of the hip joint

Abstract

Acute septic arthritis of the hip joint is an orthopaedic emergency that demands immediate recognition and effective treatment to maximize the changes of a satisfactory longterm outcome and to prevent growth anomalies and limitation of hip joint. Diagnosis may be difficult. The reasons of delay in the diagnosis of pediatric septic hips have been searched in this study. From 1986 until 1996, 21 children were operated in our department with acute septic arthritis of the hip joint. The right hip was involved in 14 patients and the left hip in 7 patients. The final results were classified clinically and anatomically. Based on the clinical grading, 11 (52%) patients had good and excellent results and 10 (48%) had fair and bad results. 10 (48% ) excellent and good, 11 (52%) fair and bad results were obtained according to roentgenographic changes. Delay in the diagnosis were observed in 7 (%70) patients among 10 clinically bad and fair results, in 8 patients (%72) among 11 anatomically bad and fair results. The reasons of delay in the diagnosis of septic arthritis of the hip joint were; referals from other hospitals, lack of suspicion in children with septicaemia whom were admitted in pediatric clinics, misdiagnosis as lots of conditions that can mimic septic arthritis and finally lack of experiences in this subject.