Septic Hip in Children

Infections of the Hip Joint in Young Children

Doctor preparing patient for MRI
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A septic hip is an infection within the hip joint. This is an uncommon problem, but it can occur in infants and young children. Septic hips are also called septic arthritis and infectious arthritis.

Children with a septic hip have bacteria within the hip joint. The bacteria accumulate as pus and becomes painful. Children with a septic hip generally require surgery to cure the infection. Treatment must proceed quickly to ensure there is no permanent damage to the hip joint.

The organism usually responsible for the infection in infants and children is group B streptococcus, and another culprit may be Haemophilus influenza (Hib) if the child hasn't had the vaccine for it. In adults, it is often caused by Staphylococcus or Streptococcus bacteria.

Symptoms of Septic Hip

Babies, children and adults who have infections of the hip joint usually have some or all of the following symptoms:

  • Fever
  • Pain with movement of the hip. Babies may be fussy during a diaper change. The pain may be severe.
  • Difficulty walking or a limp. They may be unable to move the leg of the infected hip.
  • Joint swelling, joint redness.
  • The symptoms come on swiftly.

How is Septic Hip Diagnosed?

You should take the child to a doctor if there are symptoms of septic arthritis. Examination of the child is important to determine the location of the problem. If a hip infection is suspected, blood tests can assess for signs of infection and inflammation, including a blood culture.

X-rays are usually done to evaluate for problems of the bones around the hip joint. Other tests such as MRI or ultrasound may be done to see if there is fluid accumulating within the hip joint.

If a septic hip is suspected, a needle is inserted into the hip joint. The fluid from the hip can be analyzed.

If bacteria are seen within the fluid, an infection is presumed, and surgery should be performed to clean the hip joint. If an infection is not obvious, the fluid can be analyzed for evidence of infection. Other problems that are not as serious, such as transient synovitis of the hip, can cause similar symptoms as a septic arthritis.

Treatment of a Septic Hip Joint

The infection is treated with antibiotics. As soon as the hip aspiration shows bacteria, they will start antibiotics, which may be modified once the organism's susceptibility is known from culture. Antibiotic treatment will continue for three or more weeks.

Infections within the joint require surgery for treatment. The infection within the joint can damage the cartilage permanently. If an infection of the hip is diagnosed in your child, he or she will have surgery to clean out the joint. This can be arthrotomy, or they may do joint irrigation and aspiration guided by ultrasound each day.

Timely treatment of a hip infection in a child is important.

Because the hip is still growing, it is of utmost importance to protect the cartilage. Patients who sustain damage to their cartilage are risking permanent hip joint damage. These patients may require hip replacement later in life if the damage to the cartilage is severe.

Sources:

Sucato DJ, Schwend RM, Gillespie R. "Septic Arthritis of the Hip in Children J. Am. Acad. Ortho. Surg., Oct 1997; 5: 249 - 260.

Septic Arthritis, Jatin M. Vyas,U.S. National LIbrary of Medicine, 5/1/2015.

Rutz E, Spoerri M. "Septic arthritis of the paediatric hip - A review of current diagnostic approaches and therapeutic concepts." Acta Orthop Belg. 2013 Apr;79(2):123-34.

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