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  • Differential
    • Traumatic causes: non-accidental trauma, fracture, dislocation, sprain, strain, tendonitis, osgood schlatter
    • Non-traumatic causes: septic arthritis, transient synovitis, osteomyelitis, SCFE, LCP disease, rheumatologic disease, bony tumors
  • Work-up
    • XRay
    • Labs to evaluate for septic arthritis – CBC BMP ESR CRP
  • Kocher Criteria
    • Non-weight bearing
    • Fever >38.5C
    • ESR >40
    • WBC >12
  • Kocher Criteria Statistics
    • 0 points: 0.2% (or 2% in prospective studies)
    • 1 point: 3% (or 9% in prospective studies)
    • 2 points: 40%
    • 3 points:93%
    • 4 points: 99%
  • Septic Arthritis DX
    • >50,000 WBC
      • Age 0-3mo : group B strep
      • Age 3mo – 12 years: Staph Aureus
      • Age 12-18 years: Gonorrhea
      • Sickle Cell Disease: Salmonella