Tom Smith arthritis is:

Ref: Apley's System of Orthopaedics and Fractures, 9th editionExplanation:TOM SMITH ARTHRITISIt is septic arthritis of the hip in the infant.The femoral head at this stage is completely cartilaginous.If not treated early, the whole femoral head is destroyed, without any potential for a normal hip joint.Treatment - Urgent arthrotomy and lavage of the hip joint.Sample has to be obtained from the hip. either by aspiration or on arthrotomy, prior to starting on antibiotic, unless patient is toxic.Empirical antibiotics are started.Definitive antibiotic is started once organism culture and antibiotic sensitivity testing reports are available.ORGANISMS CAUSING SEPTIC ARTHRITIS AT DIFFERENT AGESInfants < 6 monthso Caused by wide range of organismso Broad spectrum bacteriocidal agent is required.o DOC-Cloxacillin, Methicillin, Kanamycin.6 months to 2 yearso Most common organism is Haemophilias influenza.o DOC-Ampicillin.More than 4 yearso Most common organism is staphylococcio DOC-Methicillin or Cloxaciilin.