Management of septic arthritis in children.

Forty-five children underwent initial nonoperative treatment of hematogenous septic arthritis in joints other than the hip. Only joints with symptoms for less than 6 days and without associated osteomyelitis were included. Thirty-four of the 49 joints were successfully managed by aspiration and antibiotics, whereas the remaining joints were successfully managed by surgical drainage following a lack of response to nonoperative treatment. All children had a satisfactory result after an average follow-up of greater than 3 years. Early diagnosis and treatment are more important than the method of drainage. If a lack of response is seen to initial nonoperative treatment, surgical drainage will still lead to a satisfactory outcome.