Clinical Prediction Algorithm of Kocher et al for the Distinction of Septic Arthritis from Transient Synovitis of the Hip in a Child with Irritable Hip
Kocher et al identified factors indicative of septic arthritis of the hip in a child. This can help in the distinction between septic arthritis and transient synovitis. The authors are from Children's Hospital at Harvard Medical School.
Parameters:
(1) history of fever (presence of oral temperature > 38.5°C during the week prior to initial evaluation)
(2) weight bearing on ipsilateral leg
(3) erythrocyte sedimentation rate (ESR)
(4) peripheral white blood cell (WBC) count per µL
Parameter
Finding
Points
history of fever
none
0
present
1
weight bearing on leg
able to bear weight
0
unable to bear weight
1
ESR
< 40 mm per hour
0
>= 40 mm per hour
1
WBC count
<= 12,000 per µL
0
> 12,000 per µL
1
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 4
• The higher the score the more likely septic arthritis of the hip is present.
Total Score
Probability of Septic Arthritis
0
< 0.2%
1
3%
2
40%
3
93%
4
99.6%
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