Septic Arthritis of the Wrist.
Septic Arthritis of the Wrist. J Am Acad Orthop Surg. 2018 Jan 11;: Authors: Jennings JD, Ilyas AM Abstract Septic arthritis of the wrist is an uncommon condition, but one that can result in substantial morbidity. Timely identification and treatment is critical to patient care. No serum laboratory values have been shown to consistently confirm wrist joint infection. Thus, diagnosis is made based mainly on a thorough patient history, physical examination, and joint aspiration. When infection is suspected, aspiration of the wrist should be performed to confirm the diagnosis. Broad-spectrum antibiotics and joint aspiration or surgery are required to manage the infection and prevent sequelae. PMID: 29329124 [PubMed - as supplied by publisher]
AbstractTo assess the diagnostic value of ultrasound-guided (US-guided) synovial biopsy in routine clinical practice in cases of acute and chronic arthritis. A retrospective, single-center study of US-guided synovial biopsies between 2003 and 2013. The clinical, laboratory, radiographic, synovial fluid, and histological and bacteriological results of synovial biopsies were analyzed. Arthritis was classified according to disease duration
Septic arthritis must be considered in the setting of an acute hot and swollen joint. This disease entity is disabling and potentially life-threatening, destroying cartilage within days of onset, and with a reported mortality rate of 5%-50%.1-8 A delay in diagnosis has been described as a major contributor to poor outcome.2,4,7-9
We sought to identify trends in variables that may serve as contraindications to performing image-guided joint aspiration for suspected septic arthritis.
We present a case of a 56-year-old Bangladeshi woman who underwent focused right inferior parathyroidectomy for primary hyperparathyroidism from a right inferior parathyroid adenoma. On the first post-operative day, she complained of left elbow painful swelling with redness and warmth. Arthrocentesis of left elbow was done due to suspicion of septic arthritis. Two weeks prior to this surgery, she had sudden bilateral knee swelling was diagnosed in her home country of bilateral knee osteoarthritis with effusion and arthrocentesis showed no crystals. Aspiration of left elbow showed calcium pyrophosphate crystals, associated ...
Infection, crystal arthropathies, osteoarthritis, trauma and a variety of systemic diseases can all lead to a painful, swollen peripheral joint, septic arthritis being the most serious cause. Synovial fluid (SF) analysis is widely used to aid the diagnosis and management of both acute and chronic arthritis, and can be diagnostic in patients with bacterial infections or crystal-induced synovitis. Physicians competent in joint aspiration should be encouraged to do this unless they are dealing with a suspected infected prosthetic joint, which should be aspirated in theatre under strict asepsis.
This report describes the case of a 7-year-old boy who had pain in his right ear and limited mouth opening, following the onset of acute otitis media. A contrast-enhanced computed tomography scan revealed right-sided mastoiditis and hydrops of the right temporomandibular joint, suggesting septic arthritis. Real-time PCR and microbiologic analysis identified Streptococcus pyogenes and Staphylococcus epidermidis in the joint aspirate. Treatment with arthrocentesis and antibiotics led to full recovery of temporomandibular joint function.
A study published in the August issue of the Journal of the AAOS compares outcomes among patients with shoulder septic arthritis who were treated with arthrocentesis, open irrigation and débridement, or arthroscopic irrigation and débridement.
CONCLUSIONS It is common to introduce tissue coring with epidermis and dermis into the joint during arthrocentesis, which poses a potential risk for septic arthritis. However, tissue contamination of the joint may be reduced by flushing saline through the needle into the subcutaneous tissues prior to entering the joint capsule. PMID: 28733573 [PubMed - in process]
Authors: Jiang JJ, Piponov HI, Mass DP, Angeles JG, Shi LL Abstract INTRODUCTION: In-hospital outcomes were compared among patients with shoulder septic arthritis treated with arthrocentesis, open irrigation and débridement, or arthroscopic irrigation and débridement. METHODS: The Nationwide Inpatient Sample database was queried for all cases of native shoulder septic arthritis between 2002 and 2011. Patient demographics, comorbidities, and hospitalization complications were compared for the shoulder arthrocentesis (nonsurgical) and open or arthroscopic irrigation and débridement (surgical)...
Abstract: An acutely painful, erythematous wrist can be due to a variety of pathologic processes, including crystalline arthropathy, infection, trauma, osteoarthritis, and systemic disease. The broad differential diagnosis of the inflamed wrist and nonspecific clinical findings make accurate diagnosis challenging. There is no published clinical or laboratory criterion that reliably differentiates septic wrist arthritis from a sterile inflammatory arthropathy. For septic joint patients, long-term results are notably poorer in patients with a delay in treatment, therefore establishing evidenced-based guidelines deserves atte...