Deep Dive MW R14

EM Clerkship

* Differential
* Traumatic causes: non-accidental trauma, fracture, dislocation, sprain, strain, tendonitis, osgood schlatter
* Non-traumatic causes: septic arthritis, transient synovitis, osteomyelitis, SCFE, LCP disease, rheumatologic disease, bony tumors
* Work-up
* XRay
* Labs to evaluate for septic arthritis – CBC BMP ESR CRP
* Kocher Criteria
* Non-weight bearing
* Fever >38.5C
* ESR >40
* WBC >12
* Kocher Criteria Statistics
* 0 points: 0.2% (or 2% in prospective studies)
* 1 point: 3% (or 9% in prospective studies)
* 2 points: 40%
* 3 points:93%
* 4 points: 99%
* Septic Arthritis DX
* >50,000 WBC
* Age 0-3mo : group B strep
* Age 3mo – 12 years: Staph Aureus
* Age 12-18 years: Gonorrhea
* Sickle Cell Disease: Salmonella