A Medial Portal for Hip Arthroscopy in Children With Septic Arthritis: A Safety Study

Background: Prompt open arthrotomy is historically utilized to treat pediatric septic arthritis of the hip, but arthroscopy has been described as a valid alternative to prevent long-term sequelae. Standard hip arthroscopy in adolescents and adults utilizes lateral-based portals, but successful irrigation in infants may necessitate a medial portal due to the smaller joint size. The purpose of this study was to determine the safety of a medial hip portal in children based on its anatomic relation to neurovascular structures. Methods: A retrospective review of children 6 years of age or below with septic hip arthritis who obtained a preoperative magnetic resonance imaging (MRI) between 2009 and 2015 was performed. Multiple measures were recorded from the MRI to create a 3D cone with the vertex just posterior to the adductor longus at the convergence of the gluteal and inguinal creases—a previously described posteromedial portal—with the cone base being a circle defined as the central joint diameter. The distance to the femoral vessels and nerve were then recorded. An adult cadaver was then utilized to replicate the proposed portal starting point and trajectory to confirm that it could be reproducible in a clinical setting. Results: After applying criteria, 47 MRI were evaluated (21 boys, 26 girls) demonstrating a mean distance to femoral vessels and nerve: at insertion, 18.9 mm (minimum 10.5 mm) and at the hip joint, 11.1 mm (minimum 5.2 mm). Girls and boys d...
Source: Journal of Pediatric Orthopaedics - Category: Orthopaedics Tags: Infection Source Type: research

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CONCLUSION: In this pilot study, SMS showed a high level of diagnostic accuracy in predicting septic joints compared to other diagnostic biomarkers. This quick blood test could be an important tool for early, accurate identification of acute septic joints and need for emergent surgery, improving clinical care and healthcare spending. PMID: 31908991 [PubMed]
Source: World Journal of Orthopaedics - Category: Orthopaedics Tags: World J Orthop Source Type: research
AbstractSeptic arthritis (SA) is typically managed with antibiotic therapy with or without surgery. Little is known about how patients without surgery differ from their operatively managed counterparts. We compared SA patients who received antibiotic treatment with and without surgery. We conducted a retrospective study of patients with monoarticular septic arthritis admitted to a single tertiary care centre between 1998 and 2015. All 441 monoarticular septic arthritis patients received antibiotics; 382 were also managed operatively and 59 nonoperatively. Nonoperative patients were older (64.4 vs 58.3  years old;p&thi...
Source: European Journal of Clinical Microbiology and Infectious Diseases - Category: Microbiology Source Type: research
Conclusion Early arthroscopic treatment should be considered for all patients admitted for septic arthritis of the wrist if not contraindicated. Level of Evidence This is a Level III, retrospective review. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text
Source: Journal of Wrist Surgery - Category: Orthopaedics Authors: Tags: Scientific Article Source Type: research
Abstract Rat-bite fever is a rarely diagnosed illness caused by Streptobacillus moniliformis . Although this disease is distributed worldwide, there have been few cases reported in Europe. Here, we report a case of vertebral osteomyelitis and sternoclavicular septic arthritis caused by S. moniliformis in a Portuguese patient previously bitten by a rat. Laboratory diagnosis was performed using molecular identification. This is the first case report of rat-bite fever in Portugal. The case described here serves as a reminder for physicians to consider this diagnosis in patients who have developed fever syndromes after being i...
Source: Revista da Sociedade Brasileira de Medicina Tropical - Category: Tropical Medicine Source Type: research
Conclusion: Although pneumococcal conjugate vaccine serotypes 19A, 3, 19F and 7F remain frequent causes of IPD, non-vaccine serotypes are emerging. Our data support vancomycin treatment for children with pneumococcal meningitis given 11% of our isolates were not susceptible to ceftriaxone. It is important to consider underlying conditions predisposing to IPD in a population with high rates of pneumococcal vaccination.
Source: The Pediatric Infectious Disease Journal - Category: Infectious Diseases Tags: Original Studies Source Type: research
Surgical Infections, Ahead of Print.
Source: Surgical Infections - Category: Surgery Authors: Source Type: research
This study aims to first isolate the incidence of repeat irrigation and debridement at our home institution, then define risk factors for repeat washout for septic arthritis of the knee.MethodsRecords from all patients at a single institution with acute septic knee arthritis who had arthroscopic or open I&D of the knee joint from January 2005 – December 2015 were collected retrospectively. Patients were initially identified on the basis of diagnosis coding in the institution’s medical information system. Following collection/screening based on strict inclusion/exclusion criteria, a cohort of 63 patients was ide...
Source: Journal of Clinical Orthopaedics and Trauma - Category: Orthopaedics Source Type: research
In this report we conclude normal inflammatory markers cannot be used as exclusion criteria for the disease. We also review the body of literature to summarise the key features of the condition to assist clinicians in its diagnosis.
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research
Authors: George E, Rajalakshmi A Abstract Melioidosis is an infectious disease caused by gram negative bacterium Burkholderia pseudomallei. It is a soil and water pathogen and transmitted to humans through inoculation or inhalation. This disease is considered endemic in India and largely remains under reported. The most common presentation is pneumonia and bacteraemia, which can present acutely and as septic shock. Chronic presentation include-abscess, septic arthritis, osteomyelitis. The major risk factors are diabetes, liver disease, renal disease, chronic lung disease. In this article 18 cases have been reviewed...
Source: Journal of the Association of Physicians of India - Category: General Medicine Tags: J Assoc Physicians India Source Type: research
ConclusionThe possibility of mycoplasmal septic arthritis should be considered if patients with joint infections have a history of immunocompromised, repeated negative cultures, and poor empiric antibiotic treatment results. The rational use of nucleic acid testing technologies can help in the clinical diagnosis and treatment of mycoplasmal septic arthritis.
Source: International Orthopaedics - Category: Orthopaedics Source Type: research
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