When all four Kocher Criteria are satisfied, the diagnosis of septic arthritis has a reported likelihood between 59-99%. However, when physical exam and imaging studies are inconsistent with septic arthritis, alternative diagnoses must be considered. We present to you the case of a 9-yearold female who satisfied all four Kocher Criteria and underwent an extensive workup. She was found to have an abscess along her pelvic sidewall that extended through the greater sciatic foramen into the piriformis muscle and inferiorly along the course of the sciatic nerve. Primary source control was achieved with operative irrigation and debridement, and long-term antibiotic therapy was used for eradication.