Abstract
We report a case of suppurative arthritis of the hip. A 28-month-old boy had an elevated temperature 40°C and painful limitation of motion of his right hip. The white blood-cell count was 11500/μl and CRP was 22 mg/dl. The radiograph showed a widened hip joint space and magnetic resonance imaging (MRI) showed hip effusion. The diagnosis was established preoperatively by joint aspiration. The cultured organism was Haemofilus influenzae. Four days after the onset,we performed arthroscopic debridement and drainage. We used 2 arthroscopic portals and inserted 2 drain tubes through the arthroscopic sheath. One tube was used for intermittent injection of antibiotics into the hip joint and the other was used for continuous suction. After surgery, the body temperature and clinical indicators of inflammation improved immediately. We administered intravenous antibiotics for 10 days. No perioperative complications occurred. An MRI taken at 7 weeks after surgery showed a normal hip.
Hip arthroscopy, used as a therapeutic tool, is significantly more reliable than joint aspiration in such cases, and is less invasive than arthrotomy. Hip arthroscopy is a welcome alternative in treatment of the pediatric population.
