Our grandson was born with an infected hip. X-rays were taken but no other imaging studies were done. They operated on the hip right away. Shouldn’t they have at least done an MRI or something before doing surgery?

Septic arthritis present at birth and in early childhood is an emergency. Early diagnosis and immediate treatment are very important. Any delays can result in disastrous complications.

Complete destruction of the articular (joint) cartilage and adjacent growth plate is possible. Dislocation can result in an unstable joint. With prompt treatment, the condition may be cured and complications avoided.

Magnetic resonance imaging (MRI) is not used with this problem during the initial workup. It is expensive and time consuming and doesn’t offer any additional information. The hip in a newborn is largely formed of cartilage and soft tissue so MRI isn’t helpful in showing what’s going on in the bone.

Physicians rely on clinical signs (painful hip, loss of motion, fever), lab values, and X-rays or ultrasonography to make the diagnosis. Fluid may be removed from the joint in a procedure called joint aspiration. The results of this test help determine the most effective antibiotic to use.