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Septic Arthritis Management — RACP Paediatrics MCQ

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ModerateInfectious DiseaseSeptic Arthritis ManagementRACP Paediatrics

A 3-year-old child presents with high fever, refusal to weight-bear on the right leg, and a warm, swollen right knee with markedly reduced range of motion. ESR is 55, WCC is 18, CRP is 120. He meets 3 of 4 Kocher criteria. What is the most appropriate next step?

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Correct answer: B — Urgent joint aspiration and IV antibiotics

Meeting ≥3 Kocher criteria (fever >38.5°C, non-weight-bearing, ESR >40, WCC >12,000) gives a >93% probability of septic arthritis. Urgent joint aspiration is both diagnostic and therapeutic. IV anti-staphylococcal antibiotics should be commenced after aspiration.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Septic Arthritis