Musculoskeletal

Your ultimate resource for Musculoskeletal teaching files and Musculoskeletal imaging & case of the day. Improve your diagnostic imaging skills online.

Child, Refusal to Bear Weight
Findings, next step?
Hip Ultrasound Final Dx,
course of action?

Thumbnail imageThumbnail image
Answers
Septic Hip

  • Initial pelvic film shows widening of the Rt. Hip joint, displacement of the “capsular” and obturator fat planes, and obliteration of the iliopsoas fat plane
  • Hip ultrasound shows a Rt. Hip effusion with internal echoes, consistent with an infected hip
  • Untreated, it will progress to joint/cartilage destruction ± osteomyelitis ->growth disturbance / osteoarthritis long-term
  • Drainage (ortho consult) is the cornerstone to successful treatment; per eMedicine, an 18-ga needle is used (*this was asked once!)

 

 

Additional Information

Septic arthritis, common organisms:

Neonates / infants group D streptococcus
< 4 yo H. influ., strep. Pyogenes, S. aureus
>4 yo S.aureus
> 10yo S.aureus, Neisseria gonorrheae
Adults S.aureus

Hematogenous infection is the most common

In adults, think of the five “S” joint: Shoulder, Sternoclavicular, Spine, SI, andSymphysis pubis

In addition to drainage, also give IV antibiotics:
  • oxacillin or nafcillin

  • ceftriaxone, cefotaxime, or ceftizoxime

 

Tags
These signals are relayed buying clomid online safe which then is by a number of such as medial preoptic and paraventricular nulcei.
javporn.cc