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Experience Counts When Imaging a Limping Child


 

Children can expect complete recovery within a few weeks.

Septic arthritis. He called this condition “the scariest thing that we have to face in this age group [aged 1–4 years] in regard to the limping child.” Affected kids experience severe pain in the involved joint, most often the hip. They usually have a fever and an elevated white blood count. On radiographs, “we're looking for widening of the joint space to see if there's evidence of a hip effusion,” Dr. Senac said.

The condition is hematogenous, “so you commonly have underlying osteomyelitis coupled with the septic joint,” he noted

If conventional radiographs are nondiagnostic and the physical exam is equivocal, then an MRI or a radionuclide bone scan should be obtained on an urgent basis. “Time is of the essence, as the proteolytic enzymes from the hip infection can rapidly destroy cartilage and subsequently the hip joint,” he noted.

Treatment consists of draining the hip surgically and placing the child on intravenous antibiotics.

If there is adjacent osteomyelitis, then this bone needs to be drained, generally by drilling.

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