Suppurative arthritis of the hip in children

Of 37 children treated at the Mayo Clinic for suppurative arthritis of the hip and followed for at least one year (average, 8.3 years), 19 had a satisfactory result and 18, an unsatisfactory result. An analysis of the records of the 37 children revealed the following: (1) duration of symptoms was the most important prognostic feature, there being no unsatisfactory results if treatment was instituted less than four days after onset of symptoms; (2) 14 of 16 patients with associated osteomyelitis and 6 of 8 with so called penicillin resistant Staphylococcus aureus had unsatisfactory results; (3) if symptoms had been present for more than ten days or if there was osteomyelitis, at least 2 weeks of parenteral antibiotics with arthrotomy and continuous irrigation offered the best prognosis; and (4) the prognosis has improved in recent years, possibly due to a more vigorous policy of early arthrotomy.