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Septic arthritis of the hip — MCCQE Part 1 MCQ

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ModerateJoint PainSeptic arthritis of the hipMCCQE Part 1

A 3-year-old boy has high fever 40C x 3 days, refuses to weight-bear on right leg. Right hip held in flexion/abduction/ER. WBC 18, ESR 55, CRP 85. US: right hip effusion. Most appropriate next step?

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Correct answer: B — Urgent hip aspiration and empirical IV antibiotics

Kocher criteria 4/4 (fever, non-weight-bearing, elevated ESR, elevated WBC) = >99% probability of septic arthritis. Urgent aspiration is diagnostic and therapeutic. IV antibiotics (cefazolin for Staph aureus) immediately after aspiration.

Reference: CPS Paediatric Orthopaedics