Outcome of infantile septic arthritis of the hip joint: A two-children medical center's experience.

PURPOSE: Suppurative arthritis of the hip (SAH) in infants under six months of age is prone to misdiagnosis and missed diagnosis in clinical practice, leading to catastrophic outcomes. Our study aimed to investigate the clinical prognosis of SAH in children under six months of age. METHOD: Children with SAH who underwent surgery at our hospitals between January 2010 and December 2019 were the subject of a retrospective analysis. We utilized Forlin’s classification and Bennett’s radiological grade to assess hip joint deformations in the last follow-up.

RESULTS

A total of 13 children with SAH under 6 months of age were included, with an average age of 1.8 months (1–4 months). 11 patients were referred to our department due to " absence of movement " and only 3 cases (23.1%) involved fever (body temperature exceeding 38 °C). Two children were sent to our hospital for treatment after being misdiagnosed as DDH in other hospitals and treated unsuccessfully for with Pavlik braces. Delayed treatment for approximately 2 weeks. The mean follow-up duration was 3.1 years. Forlin’s classification system during the final follow-up assessment. The distribution of residual deformities was as follows: 1A7 cases, 1B2 cases, 2 A 4 cases, and 2B 0 cases. 4 hips underwent subsequent reconstruction surgery.

CONCLUSION

Early diagnosis can significantly reduce the adverse prognosis of SAH in children under 6 months of age, and hip ultrasound reports should not replace thorough physical examination. Understanding how to differentiate ultrasound images, prioritizing the integration of clinical extensive physical examination, and being aware of SAH are all required.