Septic hip arthritis: diagnosis and arthrocentesis using bedside ultrasound.

BACKGROUND: Septic arthritis of the hip is an infrequent disorder that is difficult to diagnose. Traditional methods of obtaining synovial fluid from the hip are not always available in most emergency departments.

OBJECTIVE: To report a case of atypical septic arthritis with the diagnosis and management significantly aided by the use of bedside ultrasound.

CASE REPORT: An 18-year-old pregnant woman presented with right hip pain, a normal temperature, and elevated inflammatory markers. She had no risk factors for septic arthritis. The differential diagnosis was broad, but the use of bedside ultrasound assisted in rapidly narrowing the differential, as well as guiding the diagnostic procedure.

CONCLUSIONS: Bedside ultrasound is a useful tool to evaluate inflammatory disorders of the hip and assists in hip arthrocentesis, a procedure that has not been traditionally performed by most emergency physicians.