Septic arthritis of the hip - current concepts

Septic arthritis of the hip is the commonest septic condition during growth, reaching a distinct peak in frequency during infancy. The aetiology is a haematogenous joint infection. Indicative signs are severe pain when moving the joint, septic appearance and a poor general condition of these small and young patients. The diagnosis often can be difficult in infants since septic temperatures are not always present. An ultrasound scan shows the hip joint effusion and the capsular distension. X-ray investigation helps to exclude defective situations. Therapeutic options are: in patients with short history without radiologically visible complications we recommend repeated arthroscopic irrigation and in patients with long history and a radiologically visible defect of the femoral head or dislocation we recommend arthrotomy and open revision or reduction of the hip joint.