Kocher Criteria for Septic Arthritis of the Hip
Differentiates septic arthritis from transient synovitis in children with acute hip pain. Each predictor increases the probability of septic arthritis multiplicatively.
Score interpretation
0–1 predictor — very low probability of septic arthritis (~0.2–3%)
→ Likely transient synovitis; discharge with analgesia; if 1 predictor, consider ultrasound and orthopaedic review if not improving in 24–48h
2 predictors — intermediate probability (~40%)
→ Orthopaedic review; ultrasound-guided aspiration to rule out effusion; consider admission for IV antibiotics if clinical concern
≥3 predictors — high probability of septic arthritis (>93%)
→ Emergency orthopaedic consultation; urgent surgical washout of joint; IV antibiotics (anti-staph); blood cultures before antibiotics
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;81(12):1662–1670.
Related
Curated clinical cross-links plus same-class fallbacks.
- Hydrocortisone (ICU — Stress Dosing) · Corticosteroid (ICU/Septic Shock)
- Melatonin · Melatonin Receptor Agonist
- Phytomenadione (Vitamin K1) · Vitamin K (clotting factor cofactor)
- Phytomenadione (Vitamin K1) · Vitamin K (Coagulation Factor Synthesis)
- Hydroxychloroquine · Aminoquinoline — Malaria Prophylaxis / SLE / Rheumatoid Arthritis
- Ibuprofen (Orthopaedic Musculoskeletal Pain) · NSAID — Non-selective COX Inhibitor
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.