UMEM Educational Pearls

Category: Orthopedics

Title: Kocher Criteria for Childhood Septic Joint

Keywords: kocher, septic arthri (PubMed Search)

Posted: 6/18/2011 by Michael Bond, MD (Updated: 4/20/2024)
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Kocher Criteria for Septic Arthritis in Children:

Septic arthritis should be suspected in children that have a painful joint especially if they do not want to weight bear.  Orthopedics uses the Kocher Criteria to determine the probability of whether the joint is infected. 

Four elements make up the criteria:

  • Erythrocyte Sedimentation Rate >40
  • WBC > 12
  • Non weight-bearing on the affected joint
  • Fever.

If only one sign is present there is a 3% chance the child has a septic joint.

  • 2/4 criteria = 40%
  • 3/4 criteria = 93%
  • 4/4 criteria = 99%