Kocher Criteria for Septic Arthritis
Predicts probability of septic arthritis vs transient synovitis in children with acute hip pain. Validated by Caird et al. with CRP enhancement.
Score interpretation
Caird 2006 (Kocher criteria with CRP): probability of septic arthritis in children selected for hip aspiration; it is lower in unselected children. If CRP was not measured, use the 4-predictor Kocher criteria.
→ Clinical judgement: hip ultrasound and senior / orthopaedic review if concern persists; safety-net advice.
Caird 2006 (Kocher criteria with CRP): probability of septic arthritis in children selected for hip aspiration; it is lower in unselected children. If CRP was not measured, use the 4-predictor Kocher criteria.
→ Clinical judgement: hip ultrasound and senior / orthopaedic review if concern persists; safety-net advice.
Caird 2006 (Kocher criteria with CRP): probability of septic arthritis in children selected for hip aspiration; it is lower in unselected children. If CRP was not measured, use the 4-predictor Kocher criteria.
→ Urgent orthopaedic review: hip ultrasound and aspiration; blood cultures before antibiotics; antibiotics per local paediatric guideline.
Caird 2006 (Kocher criteria with CRP): probability of septic arthritis in children selected for hip aspiration; it is lower in unselected children. If CRP was not measured, use the 4-predictor Kocher criteria.
→ Emergency orthopaedic review for aspiration and washout; blood cultures before antibiotics; antibiotics per local paediatric guideline.
Caird 2006 (Kocher criteria with CRP): probability of septic arthritis in children selected for hip aspiration; it is lower in unselected children. If CRP was not measured, use the 4-predictor Kocher criteria.
→ Emergency orthopaedic review for aspiration and washout; blood cultures before antibiotics; antibiotics per local paediatric guideline.
Caird 2006 (Kocher criteria with CRP): probability of septic arthritis in children selected for hip aspiration; it is lower in unselected children. If CRP was not measured, use the 4-predictor Kocher criteria.
→ Emergency orthopaedic review for aspiration and washout; blood cultures before antibiotics; antibiotics per local paediatric guideline.
Interpretation bands for the Kocher Criteria. Apply clinical judgement and local guidance.
References
- Kocher MS et al. Differentiating between septic arthritis and transient synovitis of the hip in children. J Bone Joint Surg Am. 1999.
- Caird MS et al. Factors distinguishing septic arthritis from transient synovitis of the hip in children. A prospective study. J Bone Joint Surg Am. 2006.
Related
Curated clinical cross-links plus same-class fallbacks.
- Ibuprofen (Orthopaedic Musculoskeletal Pain) · NSAID — Non-selective COX Inhibitor
- Vancomycin (Orthopaedic Bone and Joint Infections) · Glycopeptide Antibiotic
- Teicoplanin (Orthopaedic Bone and Joint Infections) · Glycopeptide Antibiotic
- Paracetamol (Paediatric) · Analgesic / Antipyretic — First-Line Pain and Fever in Children
- Morphine (Paediatric) · Opioid Analgesic — Moderate to Severe Pain in Children
- Hydrocortisone (ICU — Stress Dosing) · Corticosteroid (ICU/Septic Shock)
- Infective Endocarditis · ESC 2023 Infective Endocarditis Guidelines; NICE NG41
- Eczema Herpeticum · BAD; NICE CKS
- Suspected Bacterial Meningitis (Adult) · NICE NG240 (2024); NICE NG143 (paeds)
- Clostridioides difficile Colitis · NICE NG199 (2021); IDSA/SHEA 2021
- Returning Traveller — Fever · NaTHNaC; PHE; ESCMID 2018
- Malaria — Diagnosis & Management · PHE 2016; WHO 2023
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.