Paeds Cases · rheumatology-musculoskeletal-and-sports
Explain the Kocher prediction rule to a family with an irritable hip — OSCE
OSCE communication and shared decision-making station: explaining the assessment and management of a suspected septic hip to the parents of a five-year-old boy, addressing the Kocher prediction rule in plain language, the need for urgent aspiration and washout, the reassurance about transient synovitis when the score is low, and the plan for follow-up.
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Candidate brief
You have eight minutes to counsel the parents of a five-year-old boy who is suspected to have a septic hip, confirmed by a high Kocher score, a hip ultrasound showing an effusion, and an elevated C-reactive protein. Use a structured, honest, empathic approach that explains the problem in plain language, addresses the parents' fears and the playground theory, and builds a shared plan for the aspiration and the possible operation. [4] [8]
You have read the opening of this case. The complete unit — every section and its primary-source references — is part of the Paediatrics Fellowship fellowship atlas.
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- [4]Kocher MS, Zurakowski D, Kasser JR. Differentiating between septic arthritis and transient synovitis of the hip in children: an evidence-based clinical prediction algorithm. Journal of Bone and Joint Surgery. American Volume, 1999.PMID 10608376
- [7]Payares-Lizano M. The limping child. Pediatric Clinics of North America, 2020.PMID 31779828
- [8]Adamson J, Waterfield T. Fifteen-minute consultation: the limping child. Archives of Disease in Childhood. Education and Practice Edition, 2020.PMID 31255998