Suppurative arthritis of the hip in children

Of thirty-seven children treated at the Mayo Clinic for suppurative arthritis of the hip and followed for at least one year (average, 8.3 years), nineteen had a satisfactory result and eighteen, an unsatisfactory result. An analysis of the records of the thirty-seven children revealed the following: (1) duration of symptoms was the most important prognostic feature, there being no unsatisfactory results if treatment was instituted less than four days after onset of symptoms; (2) fourteen of sixteen patients with associated osteomyelitis and six of eight with so-called penicillin-resistant Staphylococcus aureus had unsatisfactory results; (3) if symptoms had been present for more than ten days or if there was osteomyelitis, at least two weeks of parenteral antibiotics with arthrotomy and continuous irrigation offered the best prognosis; and (4) the prognosis has improved in recent years, possibly due to a move vigorous policy of early arthrotomy.