Editor,— As Mattick et al¹ explain, the irritable hip is a common presentation that requires the exclusion of serious pathology. The protocol described allows appropriate outpatient management of many children. The text describes how no one single investigation or examination finding is predictive of septic arthritis. We were however disappointed to see a “blanket” approach to investigations with all children undergoing blood tests.

History and examination are more useful than any investigation. If a child has been unwell, whether feverish or not, septic arthritis should be considered and appropriate investigation and treatment instituted. …