Saturday, December 10, 2016

Transient synovitis vs septic arthritis


In this post, I'll talk on how to to differentiate transient synovitis from septic arthritis.

Transient arthritis is non specific inflammation of the synovium, related to infection or trauma.

Septic arthritis is bacterial infection of the synovium of the joint.

Modified Kochers criteria can help distinguish the two.

Fever > 38.5
ESR > 40 mm/hr
WBC > 12,000 cells/mL
CRP > 20 mg/dL
Inability to bear weight on the affected limb

More the criteria, more likely the child has septic arthritis.

Here's a mnemonic for modified Kochers criteria: FEW Can Bear Kocher!

Fever, ESR, WBC, CRP, weight bearing.

Acute transient synovitis is the most common cause of painful hip in a child younger than 10 years. It is a diagnosis of exclusion and can mimic Osteoarthritis, Legg Calve Perthes disease, SCFE.

Treatment: Rest, anti inflammatory agents.

That's all!

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