🦴 Chapter 726 · Septic Arthritis

Nelson Textbook of Pediatrics 22nd Edition | Septic arthritis = bacterial infection of the joint space. Surgical emergency — delay can cause cartilage destruction, AVN (hip). S. aureus most common (including MRSA). Kingella kingae common in young children (6m-4y). Kocher criteria predict septic arthritis risk: fever >38.5°C, non-weight-bearing, ESR >40, WBC >12,000. Hip septic arthritis — most serious (blood supply). Diagnosis: joint aspiration (WBC >50,000, Gram stain, culture, PCR for Kingella). Treatment: surgical irrigation and debridement (arthrotomy or arthroscopy) + IV antibiotics. Duration: 10-14 days for uncomplicated; 3-4 weeks if concomitant osteomyelitis.

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📋 30 Clinical Scenarios — Septic Arthritis

📇 High‑Yield Review Cards

🩺 Clinical Recognition: Septic Arthritis

Select a presentation to review diagnostic clues and management per Nelson Ch 726.

📋 Stepwise Management of Septic Arthritis

🔑 Key Principles — Nelson Chapter 726
• Surgical emergency — cartilage destruction within hours.
• Kocher criteria: Fever >38.5°C, non-weight-bearing, ESR >40, WBC >12,000. 4/4 = 99% risk.
• Hip septic arthritis — most serious (vascular compromise). Urgent aspiration + irrigation.
• Diagnosis: Joint aspiration → WBC >50,000 (often >100,000), Gram stain, culture, PCR for Kingella.
• Treatment: Surgical irrigation (arthrotomy/arthroscopy) + IV antibiotics (10-14 days for uncomplicated; 3-4 weeks if osteomyelitis).
• Lyme arthritis: large effusion, mild pain, serology, treat with doxycycline/amoxicillin.

    ⚡ Reflex Prompts — Clinical Decisions

    📖 Summary: Septic Arthritis (Nelson 726)