Hip pain and fever: when it's not a septic joint, what's next?

Hip pain and fever in children include a broad differential. Most concerning is the possible diagnosis of a septic joint, which carries significant morbidity. We describe the case of a 13-year-old boy with fever and hip pain who was referred to the emergency department with concern for septic hip. The etiology was later discovered to be pyomyositis from methicillin-resistant Staphylococcus aureus. In areas with high prevalence of community-acquired methicillin-resistant Staphylococcus aureus, it is important for physicians to be aware of this rare, but potentially complicated condition.