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Elevated absolute neutrophil count
3%
57/1825
Serum white blood cell count > 12,000 cells/cubic millimeter
88%
1614/1825
Positive blood cultures
6%
102/1825
Pain with hip extension
1%
17/1825
Symptoms greater than 3 days
22/1825
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In the classic article by Kocher et al, the authors reviewed pediatric patients with septic arthritis and concluded that four independent multivariate clinical predictors were identified to differentiate between septic arthritis and transient synovitis: history of fever, non-weight-bearing, erythrocyte sedimentation rate of at least forty millimeters per hour, and serum white blood-cell count of more than 12,000 cells per cubic millimeter (12,000 cells/cubic millimeter). The predicted probability of septic arthritis was determined for all sixteen combinations of these four predictors and is summarized as less than 0.2 % for zero predictors, 3% for one predictor, 40% percent for two predictors, 93% for three predictors, and 99% for four predictors. Caird et al performed a study that concluded that a temperature above 38.5 was the best predictor of septic arthritis followed in decreasing order by CRP>2 mg/dL, ESR, refusal to bear weight, and WBC count in the serum. Illustration A is a table that compares Kocher's original 4 factors (ESR, WBC, fever, refusal to bear weight) and Caird's addition of CRP>2 mg/dL as a 5th factor.
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