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Treatment of septic hip in a pediatric ED: a retrospective case series analysis
Pavel Kotlarsky1, Itai Shavit2, Imad Kassis3
1Orthopedic Surgery Department, Rambam Health Care Campus, Haifa, Israel.
Insights
Aspiration of the hip joint in the emergency department (AHED) is an effective treatment for pediatric septic hip. This approach, with repeat aspirations as needed, led to full recovery without disability in all treated children.
Area of Science:
- Pediatric Orthopedics
- Emergency Medicine
- Infectious Diseases
Background:
- Pediatric septic hip is a critical condition requiring prompt diagnosis and intervention.
- Early recognition and treatment are vital to prevent long-term complications.
Purpose of the Study:
- To describe the clinical course of children with septic hip treated with aspiration of the hip joint in the emergency department (AHED).
- To evaluate the effectiveness of AHED as a primary treatment modality.
Main Methods:
- Retrospective case series analysis of 17 children diagnosed with septic hip between 2007 and 2014.
- Diagnosis was confirmed using point-of-care ultrasonography by emergency physicians.
- Treatment involved AHED, with follow-up sonographic examinations and additional aspirations under sedation as necessary.
Main Results:
- All 17 children with septic hip were treated with AHED.
- No patient required arthrotomy; all recovered without disability.
- Median antibiotic treatment duration was 28 days, with 41% requiring repeat aspirations under sedation.
Conclusions:
- AHED, supplemented by repeat aspirations when indicated, is an effective treatment for pediatric septic hip.
- This minimally invasive approach can lead to excellent outcomes, avoiding the need for surgical intervention.
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.
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