Table 1 Manifestations associated with early diagnosis of SHA
From: Diagnosis and surgical treatment of chronic destructive septic hip arthritis
Category | Specific manifestations |
|---|---|
Symptoms | |
 Pain | Persistent hip joint pain, aggravated by activity |
 Limited mobility | Reduced range of motion in the hip joint, limited flexion, abduction and internal rotation |
 Fever | Low-grade or intermittent fever |
 Systemic symptoms | Fatigue, loss of appetite, weight loss, etc |
Signs | |
 Swelling | Soft tissue swelling around the hip, possibly accompanied by redness and increased skin temperature |
 Tenderness | Significant tenderness in the anterior hip or groin area |
 Joint deformity | Flexion contracture (chronic infection) |
 Sinus | Skin sinuses accompanied by purulent discharge (advanced stages of chronic infection) |
Laboratory Tests | |
 WBC | Elevated WBC and neutrophil percentage (active infection) |
 CRP and ESR | Significantly elevated |
Joint fluid analysis | Purulent and significantly elevated WBC (usually > 50,000/mm3) Gram staining, positive culture and mNGS |
Imaging | |
 X-ray | Joint space narrowing, bone destruction, osteoporosis, periarticular sclerosis and osteophyte (late stage) |
 CT | Bone destruction, sequestrum formation and periarticular abscesses |
 MRI | Joint effusion, synovial thickening, bone marrow edema and surrounding soft tissue infection |