EM Clerkship

Deep Dive MW R14


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* 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





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EM ClerkshipBy Zack Olson, MD ; Mike Estephan, MD ; Maddie Watts, MD