› Kocher criteria for septic arthritis of the hip
› Fever greater than 38.5 C
› Non weight bearing
› ESR greater than 40 mm/hour
› WBC greater than 12 x 10 to the 9 per L
› Increasing probability with more criteria present
› Limited performance in settings with Lyme or early infection
› Modified Kocher including CRP
› CRP greater than 20 mg/L
› Useful for risk stratification not rule out
› MRI indications
› Suspected osteomyelitis with negative radiographs
› Suspected septic arthritis complications
› Concern for malignancy or occult fracture
› MRI precautions
› Sedation needs in younger children
› Implanted device compatibility
› MRI pearls
› Detects marrow edema early in osteomyelitis
› Defines abscess and adjacent soft tissue involvement
› CT indications
› Complex fracture characterization
› Suspected pelvic or acetabular injury when radiographs limited
› CT limitations
› Ionizing radiation
› Contrast nephrotoxicity risk when used
› CT alternatives
› Prefer MRI for infection and malignancy workup
› Prefer ultrasound for hip effusion screening
› Hip ultrasound
› Detects effusion
› Cannot distinguish septic arthritis from transient synovitis alone
› POCUS adjuncts
› Guidance for arthrocentesis when expertise available
› Soft tissue abscess identification
› Radiograph strategy
› Joint above and below the suspected site
› Pelvis AP plus lateral hip view when hip pathology possible
› Tibia and fibula views for toddler fracture phenotype
› SCFE safety
› Avoid frog leg lateral if unstable SCFE suspected
› Use cross table lateral if SCFE concern
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