Child Orthopedics

Frequently Asked Questions

Please help us -- our seven-year-old grandson has septic arthritis of the hip. He's been hospitalized for treatment. There's a real concern about the infection going into the bone. What would cause this to happen? Can we do anything? How likely is it? I'm just so worried, I can't think straight.

Most people are familiar with strep throat or a staph infection in children. But these bacteria can enter the bloodstream and travel throughout the body. For some as yet unknown reason, the bacteria take up residence in the joints and cause a septic (infectious) arthritic response. The child develops a fever and joint pain. Most often the hip or knee is affected. But sometimes the shoulder or elbow becomes septic. Movement of the affected extremity can hurt. If the arm is affected, the child may stop using it. If the leg is affected, the child may develop a limp or stop standing/walking on that side. Treatment is imperative in order to avoid complications like bone deformity, joint dislocation, osteomyelitis (bone infection), and halting growth that can result in limb length differences of the infected arm or leg. So, if your grandson is hospitalized, he is likely getting everything he needs to prevent further complications. The family can offer love, prayers, and support -- that can go a long way sometimes. If the antibiotic he's on doesn't work, a different antibiotic can be tried. Surgical drainage of the joint helps clear out as much local infection as possible while the antibiotic works both systemically (throughout the entire body) and locally (at the affected joint). In a recent study comparing children with hip versus shoulder septic arthritis, more children with shoulder involvement developed osteomyelitis. Those with hip infection were less likely to develop this complication. Should osteomyelitis develop, intravenous antibiotic therapy will be extended for four to six weeks. When the blood work shows success with normal inflammatory markers, then the child can be switched to an oral (pill taken by mouth) antibiotic. The oral antibiotic is usually taken until symptoms have resolved, blood remains clear, and X-rays are normal.

Mohan V. Belthur, MD, et al. A Clinical Analysis of Shoulder and Hip Joint Infections in Children. In Journal of Pediatric Orthopaedics. October/November 2009. Vol. 29. No. 7. Pp. 828-833.

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