{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T16:53:24Z","timestamp":1790614404314,"version":"4.1.0"},"reference-count":38,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T00:00:00Z","timestamp":1759795200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>In children under 4, septic arthritis of the hip (SAH) caused by Kingella kingae (SAH-KK) can be misdiagnosed, as it does not meet classic septic joint criteria (fever &gt; 38.5\u00b0, pain, limited range of motion, and inability to bear weight). The objective of this study was to report clinical and paraclinical characteristics in a large cohort of children with confirmed SAH-KK and to evaluate the reliability of the Kocher (KC) and Caird criteria (CC) in predicting SAH-KK. Medical records of 140 children with confirmed SAH-KK were collected. Data on sex, age, temperature on admission, weight-bearing status, white blood cell (WBC) count, platelet count, C-reactive protein (CRP) value, and erythrocyte sedimentation rate (ESR) were extracted. The study focused on the sensitivity of KC (body temperature, refusal to bear weight, leukocytosis, and ESR) and CC (KC criteria plus CRP level). All patients had bacteriologically confirmed SAH-KK; most had mild symptoms and near-normal inflammatory markers. CRP (76.2%) had the highest sensitivity, followed by weight-bearing status (73.8%) and WBC count (69.6%). Body temperature and ESR exceeded cutoff values in less than 50% of cases. Among 77 patients fulfilling all KC, 49 (63.5%) had less than a 40% probability of SAH. Of 50 children with complete CC, 20 (40%) had a 62.4% or lower probability of SAH. KC and CC are not sufficiently accurate to confidently exclude SAH-KK in preschool-aged children due to heterogeneous clinical presentations. Further studies are needed to redefine diagnostic criteria based on patient age and causative pathogens.<\/jats:p>","DOI":"10.3390\/microorganisms13102323","type":"journal-article","created":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T15:48:30Z","timestamp":1759852110000},"page":"2323","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Inefficiency of Kocher and Caird\u2019s Criteria in Septic Arthritis of the Hip Due to Kingella\u00a0kingae: A Multicenter Retrospective Cohort Study"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-2455-6224","authenticated-orcid":false,"given":"Giacomo","family":"De Marco","sequence":"first","affiliation":[{"name":"University Hospitals of Geneva, 1205 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1325-8575","authenticated-orcid":false,"given":"Oscar","family":"Vazquez","sequence":"additional","affiliation":[{"name":"University Hospitals of Geneva, 1205 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blaise","family":"Cochard","sequence":"additional","affiliation":[{"name":"University Hospitals of Geneva, 1205 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piotr","family":"Foland","sequence":"additional","affiliation":[{"name":"University Hospitals of Geneva, 1205 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Meinzer","sequence":"additional","affiliation":[{"name":"Department of General Pediatrics, Pediatric Internal Medicine, Rheumatology and Infectious Diseases, National Reference Centre for Rare Pediatric Inflammatory Rheumatisms and Systemic Autoimmune Diseases (RAISE), CHU Robert Debr\u00e9, AP-HP, Universit\u00e9 Paris Cit\u00e9, 75019 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cindy","family":"Mallet","sequence":"additional","affiliation":[{"name":"Pediatric Orthopedic Department, CHU Robert Debr\u00e9, AP-HP, Universit\u00e9 Paris Cit\u00e9, 75019 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brice","family":"Ilharreborde","sequence":"additional","affiliation":[{"name":"Pediatric Orthopedic Department, CHU Robert Debr\u00e9, AP-HP, Universit\u00e9 Paris Cit\u00e9, 75019 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9066-6457","authenticated-orcid":false,"given":"Edouard","family":"Haumont","sequence":"additional","affiliation":[{"name":"Service de Chirurgie Orthop\u00e9dique P\u00e9diatrique, H\u00f4pital Necker-Enfants-Malades, 75015 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zagorka","family":"Pejin-Arroyo","sequence":"additional","affiliation":[{"name":"Service de Chirurgie Orthop\u00e9dique P\u00e9diatrique, H\u00f4pital Necker-Enfants-Malades, 75015 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo","family":"Yagupsky","sequence":"additional","affiliation":[{"name":"Soroka University Medical Center, Beer-Sheva 84101, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0059-8607","authenticated-orcid":false,"given":"Amadeu","family":"Gen\u00e9","sequence":"additional","affiliation":[{"name":"Hospital Sant Joan de D\u00e9u, 08950 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2400-3033","authenticated-orcid":false,"given":"Eneritz","family":"Velasco Arnaiz","sequence":"additional","affiliation":[{"name":"Hospital Sant Joan de D\u00e9u, 08950 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4162-8473","authenticated-orcid":false,"given":"Catarina","family":"Gouveia","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Diseases Unit, Hospital Dona Estef\u00e2nia, ULS S\u00e3o Jos\u00e9, Academic Clinical Centre of Lisbon, 1169-050 Lisbon, Portugal"},{"name":"Comprehensive Health Research Centre (CHRC), Nova Medical School, Faculdade Ci\u00eancias M\u00e9dicas, 1169-050 Lisbon, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joana","family":"Arcangelo","sequence":"additional","affiliation":[{"name":"Pediatric Orthopedics Unit, Hospital Dona Estef\u00e2nia, ULS S\u00e3o Jos\u00e9, Academic Clinical Centre of Lisbon, 1169-050 Lisbon, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6403-2448","authenticated-orcid":false,"given":"Nicolas","family":"Mainard","sequence":"additional","affiliation":[{"name":"Department of Pediatric Orthopedic Surgery, Faculty of Medicine, Lille University Hospital, 59037 Lille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jocelyn","family":"Gravel","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Sainte-Justine Hospital, University of Montreal, Montreal, QC H3T 1C5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tony","family":"Walls","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Child Health, University of Otago, Christchurch 8140, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nienke","family":"Hagedoorn","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Child Health, University of Otago, Christchurch 8140, New Zealand"},{"name":"Department of General Pediatrics, Erasmus MC Sophia Children\u2019s Hospital, 3015 GD Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9114-6694","authenticated-orcid":false,"given":"Ameneh","family":"Khatami","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Microbiology, The Children\u2019s Hospital at Westmead, Sydney, NSW 2145, Australia"},{"name":"Sydney Infectious Diseases Institute, University of Sydney, NSW 2145, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Tashani","sequence":"additional","affiliation":[{"name":"Specialty of Child and Adolescent Health, The Children\u2019s Hospital at Westmead, University of Sydney, Sydney, NSW 2145, 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Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3309-0722","authenticated-orcid":false,"given":"Sara","family":"Murias Loza","sequence":"additional","affiliation":[{"name":"Hospital Universitario Central de Asturias, 33011 Oviedo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Clemente","sequence":"additional","affiliation":[{"name":"Hospital Infantil Universitario Ni\u00f1o Jes\u00fas, 28009 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Canavese","sequence":"additional","affiliation":[{"name":"Department of Pediatric Orthopedic Surgery, Faculty of Medicine, Lille University Hospital, 59037 Lille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4038-4881","authenticated-orcid":false,"given":"Dimitri","family":"Ceroni","sequence":"additional","affiliation":[{"name":"University Hospitals 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