طفل عمره ٦ سنوات عنده ألم في الركبة اليسرى منذ يومين، ويرفض الحمل عليها، والركبة حمراء متورمة ودافئة جداً، ولا يتحمل أي حركة لها. الحرارة ٣٩٫٠. ما الأرجح وما الإجراء؟

A 6-year-old has had left knee pain for two days, refuses to bear weight, and the knee is red, swollen, very warm and he will not tolerate any movement. T 39.0 °C. What is likely and what is done?

1. Rheumatoid arthritis; review in a month
2. A sports sprain; ice and rest suffice
3. Growing pains; massage at night suffices
4. Septic arthritis; aspiration, urgent antibiotics

Answer: D) Septic arthritis; aspiration, urgent antibiotics. A single hot, red, painful joint with fever and refusal to bear weight is septic arthritis until proven otherwise, an emergency needing aspiration, culture, IV antibiotics and prompt washout to protect cartilage.