Related Experiment Video
Updated: Jun 15, 2026
Knee Arthrocentesis in Adults
Published on: February 25, 2022
Comparison of bacteriologically proven septic arthritis of the hip and knee in children, a preliminary study
Suraj Joshy1, Qaisar Choudry, Naveed Akbar
1Department of Orthopaedics & Trauma, Royal Manchester Children's Hospital, Manchester, UK.
Insights
Pediatric septic arthritis commonly affects the hip and knee. Septic arthritis of the knee occurred in younger children and was less likely to yield positive cultures compared to hip infections.
Area of Science:
- Pediatric Orthopedics
- Infectious Diseases
- Rheumatology
Background:
- Septic arthritis in children frequently involves the hip and knee joints.
- Diagnosis can be challenging due to overlapping symptoms like limping and general unwellness.
Purpose of the Study:
- To compare the characteristics of pediatric patients with culture-positive septic arthritis of the hip versus the knee.
- To identify differences in presentation, diagnosis, and outcomes between hip and knee septic arthritis.
Main Methods:
- Retrospective review of pediatric patients diagnosed with acute septic arthritis of the hip or knee.
- Analysis of data from patients undergoing arthrotomy for suspected septic arthritis over a 3-year period.
- Comparison of culture results, patient demographics, and clinical criteria adherence.
Main Results:
- Culture-positive septic arthritis was confirmed in 12/29 hip cases and 7/37 knee cases.
- Patients with knee septic arthritis were significantly younger than those with hip involvement.
- Knee septic arthritis cases were less likely to have positive synovial fluid cultures.
- Adherence to Kocher criteria differed between hip and knee septic arthritis presentations.
Conclusions:
- Septic arthritis of the knee in children presents differently than hip septic arthritis, particularly regarding age and culture positivity.
- Clinical diagnostic criteria may need to be adapted for differentiating septic arthritis of the knee in pediatric populations.
- Further research is warranted to refine diagnostic and treatment strategies for pediatric septic arthritis based on joint involvement.
Abstract:
The hip and knee are the commonest joints affected by septic arthritis in the pediatric age group. Both can present as a limping, unwell child and can be difficult to diagnose. The primary aim of this study is to review and compare characteristics of pediatric patients with culture positive septic arthritis of the hip to those with culture positive septic arthritis of the knee. We retrospectively reviewed all patients who were clinically diagnosed with acute septic arthritis of either hip or knee in a tertiary pediatric hospital for a period of 3 years. Twelve of 29 patients who underwent arthrotomy for presumed septic arthritis of the hip and 7 of 37 patients who underwent arthrotomy for presumed septic arthritis of the knee had positive joint cultures. Patients with septic arthritis of the knee were much younger than that with septic arthritis of the hip. Patients with presumed septic arthritis of the knee based on clinical picture were less likely to have a positive synovial fluid culture. Children with septic arthritis of the knee did not follow Kocher criteria in the same way that children with septic arthritis of the hip did.
