Joint pain in children presents a diagnostic challenge due to its multifaceted etiology, ranging from musculoskeletal injuries to systemic infections. This case report details a 3-year-and-5-month-old girl with bilateral hearing impairment and congenital cytomegalovirus infection, who was admitted with thigh pain, high fever, and difficulty walking. Despite being hemodynamically stable and without apparent infection signs, extensive diagnostic evaluations revealed gonococcal hip arthritis. This condition, caused by Neisseria gonorrhoeae, is unusual in young children and typically associated with perinatal transmission or sexual abuse. The diagnosis was confirmed through molecular testing, highlighting the importance of considering rare etiologies in pediatric joint pain cases. The patient's management included multidisciplinary consultations, various imaging and laboratory tests, and specific antimicrobial therapies. The case underscores the necessity of a comprehensive diagnostic approach in pediatric patients with joint pain, especially when associated with other health conditions, to ensure accurate diagnosis and appropriate treatment.
Trubalski et al. (Mon,) studied this question.