What is the recommended procedure for managing a pediatric septic joint?

The recommended procedure for managing a pediatric septic joint involves performing arthrocentesis, which is a procedure to aspirate fluid from the joint space. This is essential for both diagnostic and therapeutic purposes. By aspirating the joint, the physician can obtain synovial fluid for analysis to confirm the presence of infection and rule out other conditions, such as crystal arthritis or hemorrhagic effusion.

In addition to the diagnostic aspect, arthrocentesis provides symptomatic relief by reducing pressure and inflammation within the joint due to the effusion. Following the aspiration, empiric intravenous antibiotics such as nafcillin or cefazolin are initiated to address the likely causative organisms, primarily Staphylococcus aureus, including methicillin-resistant strains, and streptococci. Empiric treatment is crucial because prompt antibiotic therapy significantly reduces the risk of joint damage and improves outcomes.

Open surgery is typically reserved for cases where there is significant joint destruction, failure of medical management, or the presence of loculated abscesses that cannot be adequately drained. Observation and rest are not adequate management strategies, as septic arthritis can lead to permanent joint damage if left untreated. Oral antibiotics would not be sufficient in this acute setting, given the severity of the infection and the need for