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An 8 month old male presents with a 4-day history of decreased movement of the left hip, intermittent fever measured up to 101.5 F, and general fussiness.
Unremarkable for PMH or PSH. Full-term, spontaneous vaginal delivery without complications.
Physical exam reveals an irritable and crying infant. There is decreased active movement of the left hip during exam. The left hip is maintained in flexed and abducted position. Painful range of motion of hip; difficult to isolate any specific focal area of tenderness. He is afebrile. Labs: CRP = 5.8 mg/dl ESR = 115 mm/Hr WBC's = 12K
Aspiration of hip and proximal femur, both negative. Arthrogram performed to confirm intra-articular needle placement.