Is It Pediatric Septic Arthritis or Transient Synovitis of the Hip?
Differentiating a case of transient synovitis from septic arthritis of the hip in children can be difficult because the presentations of these two entities are similar. Fever, a limp, unwillingness to bear weight, limited motion and joint effusion can occur with both. Kocher and associates conducted a retrospective study of presenting signs in children with septic arthritis and transient synovitis of the hip. The medical records of 282 children with signs of hip inflammation were analyzed. Thirty-eight of the 282 children were considered to have had true septic arthritis as identified by a positive culture of the joint fluid or at least 50,000 white blood cells per mm3 (50 x 109 per L) in the joint fluid, accompanied by positive findings on blood culture. The diagnosis of presumed septic arthritis was given to 44 of the 282 children. These patients had a white blood cell count in the joint fluid of at least 50,000 per mm3 with negative findings on joint fluid and blood cultures. The di
