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Aspirate a suspected septic hip in a child — OSCE
OSCE procedural station: assess a 3-year-old febrile child with a suspected septic hip, score the prediction rule, exclude the relative contraindications, and outline the ultrasound-guided aspiration, the synovial fluid handling, the complications and the disposition.
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RACP DCEMRCPCH ClinicalRCPSC PediatricsABP General Pediatrics
Prompt
A 3-year-old previously well boy is brought to the emergency department refusing to walk. He is febrile at 39.1°C, holds the right hip flexed and abducted, and cries when the hip is moved. The C-reactive protein is 95 mg per litre, the white cell count is 16,000 per microlitre, and an ultrasound shows a right hip effusion. You are the paediatric registrar asked to score the risk, prepare for an ultrasound-guided hip aspiration, and outline the technique, the fluid handling, the complications and the disposition.
Candidate brief
You have this station to assess a 3-year-old febrile child with a suspected septic hip, score the prediction rule, exclude the relative contraindications, and outline the ultrasound-guided aspiration, the synovial fluid handling, the complications and the disposition. Treat this as a time-critical procedure in a high-risk child, with an explicit safety check and an ultrasound-guided single pass. [1] [3]
References4ShowHide
- [1]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.PMID 10608376
- [2]Cavalier R, Herman MJ, Pizzutillo PD, et al Ultrasound-guided aspiration of the hip in children: a new technique Clin Orthop Relat Res, 2003.PMID 14612652
- [3]Nannini A, Giorgino R, Bianco Prevot L, et al Septic arthritis in the pediatric hip joint: a systematic review of diagnosis, management, and outcomes Front Pediatr, 2023.PMID 38188916
- [4]Tantillo TJ, Boudreaux S, Katsigiorgis G Arthrocentesis StatPearls, 2026.PMID 32491737