Taylor and Clarke identified clinical risk factors associated with septic arthritis in a child presenting with irritable hip. The authors are from Southampton University Hospital in England.
Parameters (defined column 1, page 60):
(1) severe hip pain or spasm (unable to bear weight on affected limb or significant loss in range of motion in 2 or more planes)
(2) tenderness over hip or adjacent pelvis
(3) temperature within 12 hours of admission
(4) erythrocyte sedimentation rate (ESR)
Parameter
Finding
Points
severe hip pain or spasm
absent
0
present
1
tenderness on palpation
absent
0
present
1
temperature
< 38°C
0
>= 38°C
1
ESR
< 20 mm/h
0
>= 20 mm/h
1
number of risk factors =
= SUM(points for all 4 parameters)
Interpretation:
• minimum number of risk factors: 0
• maximum number of risk factors: 4
• The presence of 2 or more risk factors gave a sensitivity of 95% and specificity of 91% for septic arthritis.
• Therapy with antibiotics prior to examination may affect the findings.
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