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Septic arthritis of the hip — RCPSC EM MCQ

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HardPaediatric emergenciesSeptic arthritis of the hipRCPSC EM

A 6-year-old refuses to bear weight and has fever after a viral illness. Temperature is 39.2°C, hip range of motion is very painful, WBC is 18 x 10^9/L, ESR is 64 mm/h, and ultrasound shows a hip effusion. What is the most appropriate next step?

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Correct answer: B — Arrange urgent orthopaedic assessment for aspiration and IV antibiotics

Arrange urgent orthopaedic assessment for aspiration and IV antibiotics is correct: the clues indicate Septic arthritis of the hip and this option addresses the immediate ED priority. The distractors delay care, target a less likely problem, or are unsafe in this physiology.

Reference: Canadian paediatric orthopaedic emergency practice