Treatment of septic hip in a pediatric ED: a retrospective case series analysis

Abstract Background A pediatric septic hip is a serious condition that must be recognized and treated as early as possible. We describe the clinical course of children with septic hip that were treated with aspiration of the hip joint in the emergency department (AHED). Methods This was a retrospect...

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Published inThe American journal of emergency medicine Vol. 34; no. 3; pp. 602 - 605
Main Authors Kotlarsky, Pavel, MD, Shavit, Itai, MD, Kassis, Imad, MD, Eidelman, Mark, MD
Format Journal Article
LanguageEnglish
Published United States Elsevier Inc 01.03.2016
Elsevier Limited
Subjects
Adolescent
Airway management
Anesthesia
Anti-Bacterial Agents - therapeutic use
Antibiotics
Arthritis, Infectious - diagnostic imaging
Arthritis, Infectious - therapy
Arthrocentesis - methods
Blood
Child
Child, Preschool
Emergency
Emergency medical care
Emergency Service, Hospital
Female
Hip joint
Hip Joint - diagnostic imaging
Hip Joint - surgery
Hospitalization
Hospitals
Humans
Hypoxia
Infant
Male
Medical records
Patients
Physicians
Point-of-Care Systems
Retrospective Studies
Treatment Outcome
Ultrasonic imaging
Ultrasonography
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Summary:Abstract Background A pediatric septic hip is a serious condition that must be recognized and treated as early as possible. We describe the clinical course of children with septic hip that were treated with aspiration of the hip joint in the emergency department (AHED). Methods This was a retrospective case series analysis. Results Between January 1, 2007, and December 31, 2014, 17 children with septic hip were diagnosed by emergency physicians using point-of-care ultrasonography. All were treated with AHED. During hospital admission, a median of 2 (interquartile range [IQR], 2-3) follow-up sonographic examinations per patient was performed; 10 (59%) patients did not have another hip aspiration, and 7 (41%) had a median of 1 (IQR, 1-3) hip joint aspiration under sedation. Median length of antibiotic treatment was 28 days (IQR, 21-40). No patient underwent arthrotomy, and all recovered without disability in up to 4 years of follow-up. Conclusions The results of this cohort suggest that AHED with repeated aspirations as needed is an effective treatment for children with septic hip.
Bibliography:ObjectType-Article-1
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ISSN:0735-6757
1532-8171
DOI:10.1016/j.ajem.2015.12.090