Abstract
Differentiating septic arthritis of the pediatric hip from other causes of hip pain and effusion continues to present a diagnostic challenge for the clinician. Although septic arthritis traditionally has been reported to have a synovial white blood cell count of 75,000 cells/mm3 or greater, lower counts can be seen in this condition. In cases where a synovial sample has been obtained and the cell count falls in the intermediate range between 25,000 and 75,000 cells/mm3, it is unclear what proportion of these cases may be truly septic hips. In this evidence-based review, we examine Heyworth et al’s study focusing on the predictive value of this intermediate white cell count range in a Lyme-endemic region.
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Kocher MS, Zurakowski D, Kasser JR. Differentiating between septic arthritis and transient synovitis of the hip in children: an evidence-based clinical prediction algorithm. J Bone Joint Surg Am. 1999; 81: 1662-1670.
Caird MS, Flynn JM, Leung YL, Millman JE, D'Italia JG, Dormans JP. Factors distinguishing septic arthritis from transient synovitis of the hip in children. A prospective study. J Bone Joint Surg Am. 2006; 88: 1251-1257.
Carpenter CR, Schuur JD, Everett WW, Pines JM. Evidence-based diagnostics: adult septic arthritis. Acad Emerg Med. 2011; 18: 781-796.
Alderson M, Nade S. Natural history of acute septic arthritis in an avian model. J Orthop Res. 1987; 5: 261-274.
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Joseph J. Ruzbarsky, MD, Brian P. Gladnick, MD and Emily Dodwell, MD, MPH, have declared that they have no conflict of interest.
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Ruzbarsky, J.J., Gladnick, B.P. & Dodwell, E. Diagnosing Septic Arthritis in the Synovial White Cell Count “Gray Zone”. HSS Jrnl 12, 190–192 (2016). https://doi.org/10.1007/s11420-015-9480-6
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DOI: https://doi.org/10.1007/s11420-015-9480-6