The patient is placed on IV cefuroxime and hospitalized for operative drainage of the right hip. A beta-hemolytic strep. Early diagnosis and treatment of septic arthritis of the hip cannot be overemphasized. Fibrous deposition and lysosomal enzymes from polymorphonuclear leukocytes in synovial fluid can rapidly damage cartilage. Permanent damage will occur in only a few days if the diagnosis and treatment are delayed.
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This radiograph of a different patient at follow-up shows the result of a poorly treated septic hip. The patient's right hip shows degenerative changes. There is flattening of the femoral epiphysis with an irregular articular surface. Early effective treatment can minimize such subsequent complications. The diagnosis is particularly difficult to make in infants, who cannot voice their complaints, and especially in neonates who may not have the typical findings of fever, chills and leukocytosis.