小児化膿性股関節炎の治療経験

Treatment of Septic Arthritis of the Hip in Children

　小児化膿性股関節炎は早期診断・加療が重要である．小児化膿性股関節炎7例に発症後早期に切開排膿を行い，良好な成績を得たので報告する．早期診断に関しKocherの予測因子を用いて単純性股関節炎群と比較し，Kocherの予測因子の有用性を検討した．発症から排膿までは平均3日で，片田の判定基準では良が2例，優が5例であった．Kocherの予測因子は有用であった．関節穿刺で明らかな膿の排出を認めないときでも，Kocherの条件を3項目以上満たすときには，関節切開術を考慮すべきと考える．

　Early diagnosis and treatment are critical in septic arthritis of the hip in children. We report 7 cases that progressed favorably after surgery. For early diagnosis, we compared transient synovitis to septic arthritis using Kocher's predictive factors to determine the predictive value of his factors for identifying septic arthritis. Average symptom onset to operation was 3 days, with 2 cases evaluated as good and 5 as excellent from Katada's criterion, indicating the usefulness of Kocher's predictive factors. Surgery should be done as soon as possible when more than 3 items are satisfied, even if there is no drainage through a syringe.