Pavel Kotlarsky1, Itai Shavit2, Imad Kassis3, Mark Eidelman4. 1. Orthopedic Surgery Department, Rambam Health Care Campus, Haifa, Israel. 2. Pediatric Emergency Department, Rambam Health Care Campus, Haifa, Israel. Electronic address: i_shavit@rambam.health.gov.il. 3. Pediatric Infectious Disease Unit, Rambam Health Care Campus, Haifa, Israel. 4. Orthopedic Surgery Department, Rambam Health Care Campus, Haifa, Israel; Pediatric Orthopedic Surgery Unit, Rambam Health Care Campus, Haifa, Israel.
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.
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.