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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Joseph J. Ruzbarsky, MD, Brian P. Gladnick, MD and Emily Dodwell, MD, MPH, have declared that they have no conflict of interest.
This article does not contain any studies with human or animal subjects performed by the any of the authors.
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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
- pediatric septic hip
- synovial white cell count