Septic arthritis of the pediatric hip: update on diagnosis and treatment

Purpose of review To review the clinical diagnosis, management and natural history of septic arthritis of the hip (SAH) in the pediatric patient, and to highlight new information that may improve the management of these patients. Recent findings The basics of management of possible pediatric SAH have remained largely unchanged for generations. New questions have been raised regarding the role and timing of advanced imaging (MRI) in the evaluation of patients with possible SAH. Published criteria have been derived to guide the need for MRI studies in these patients. Validation of these guidelines continues. Recent reviews have highlighted the possibility of Lyme disease as a potential cause of monoarticular pediatric hip pain. The role of PCR technology in the diagnosis and management of SAH remains unclear at this time. Summary The child with a limp remains a common and urgent clinical concern. There may be expanded roles for MRI and PCR to better diagnose and treat the involved joint itself, as well as any associated nonarticular area of infection. Lyme disease should remain on the list of possible differential diagnoses in this population, particularly in geographic areas where the disease vector is known to be endemic.
Source: Current Opinion in Pediatrics - Category: Pediatrics Tags: ORTHOPEDICS: Edited by Daniel W. Green Source Type: research

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Discussion and conclusion: Maybe it was a case of drug-induced liver disease, however therapeutic dosages of all administered drugs only once. The mechanisms involved were not investigated, but may be the result of allergic and immunologic aspects caused by ketoprofen and facilitated by a history of hypersensitivity to other NSAIDs as reported by the patient. As for jaundice can be attributed to drug toxicity since laboratory parameters did not reveal any evidence of liver disease. PMID: 32079429 [PubMed - as supplied by publisher]
Source: Immunopharmacology and Immunotoxicology - Category: Allergy & Immunology Tags: Immunopharmacol Immunotoxicol Source Type: research
Authors: Ambrogi V, Murris M, Iriart X, Lortholary O, Roques C, Cassaing S, Malavaud S PMID: 32081504 [PubMed - as supplied by publisher]
Source: Medecine et Maladies Infectieuses - Category: Infectious Diseases Tags: Med Mal Infect Source Type: research
Authors: Yan J, Tan Y, Zhou B, Zhang S, Wang X, Liu D Abstract AIM: to evaluate the efficacy and safety of gastric per-oral endoscopic myotomy (G-POEM) for the treatment of refractory gastroparesis. METHODS: PubMed, Embase and Cochrane databases were searched and used for study inclusion. Clinical studies since January 2013 to October 2019 were identified as suitable for inclusion. Conference papers, review articles, case reports, animal studies, letters, studies with repetitive data, studies that did not mention the Gastroparesis Cardinal Symptom Index (GCSI) score/gastric emptying scintigraphy (GES) hours or ...
Source: Revista Espanola de Enfermedades Digestivas - Category: Gastroenterology Tags: Rev Esp Enferm Dig Source Type: research
Publication date: Available online 22 February 2020Source: Journal of Theoretical BiologyAuthor(s): Salihu S. Musa, Shi Zhao, Daozhou Gao, Qianying Lin, Gerardo Chowell, Daihai HeAbstractLassa fever, also known as Lassa hemorrhagic fever, is a virus that has generated recurrent outbreaks in West Africa. We use mathematical modelling to study the Lassa fever epidemics in Nigeria from 2016-19. Our model describes the interaction between human and rodent populations with the consideration of quarantine, isolation and hospitalization processes. Our model supports the phenomenon of forward bifurcation where the stability betwee...
Source: Journal of Theoretical Biology - Category: Biology Source Type: research
Authors: Abstract Here we present the case of a 50-year-old woman with acute urinary retention who was treated by the insertion of a permanent catheter. For associated headaches, fever and muscle and joint pain, the patient underwent neurologic examination, including lumbar puncture and magnetic resonance of head and spine. The results confirmed aseptic meningitis. Subsequently, the patient was hospitalized at the infectious disease clinic, where the permanent catheter was extracted after 5 days, with spontaneous micturition recovery and no post-void residual volume. The combination of aseptic meningitis and urina...
Source: Neuroendocrinology Letters - Category: Endocrinology Tags: Neuro Endocrinol Lett Source Type: research
Publication date: May 2020Source: Colloids and Surfaces B: Biointerfaces, Volume 189Author(s): Maroua Ben Haddada, Elise Gerometta, Rachid Chawech, Jonathan Sorres, Anne Bialecki, Sabrina Pesnel, Jolanda Spadavecchia, Anne-Laure MorelAbstractHubertia ambavilla, an endemic plant originating from Reunion Island in the Indian Ocean, is traditionally used as an anti-inflammatory and in healing, both for internal and external use. Polyphenolic compounds from aqueous phase extractions can reduce metal salts into nanoparticles and stabilize them in one step. Although gold nanoparticles are well described in the literature as anti...
Source: Colloids and Surfaces B: Biointerfaces - Category: Biochemistry Source Type: research
ConclusionsThe single-port approach has advantages as easier surgical planning and transition for combined and multi-quadrants surgeries: faster recovery, minimal postoperative pain and need for opioids, and excellent cosmetic outcome. We suggest that combined procedures should be performed only in high volume institutions by surgeons with vast experience in robotic surgery in selected patients.ResumenIntroducciónPresentar el primer caso de cirugía multicuadrante concomitante —prostatectomía radical robótica y nefrectomía parcial robótica izquierda— realizadas con t&eac...
Source: Actas Urologicas Espanolas - Category: Urology & Nephrology Source Type: research
Conclusion: XBJ can restore the immune balance to treat RA and CIA. Therefore, XBJ could be a potential therapeutic drug for RA. PMID: 32082396 [PubMed]
Source: Evidence-based Complementary and Alternative Medicine - Category: Complementary Medicine Tags: Evid Based Complement Alternat Med Source Type: research
Background: Lyme arthritis (LA) of the hip can present similarly to septic arthritis (SA) and transient synovitis (TS). The primary purpose of this study was to determine clinical and laboratory parameters differentiating LA of the hip from SA or TS among children who had undergone hip aspiration during the evaluation of hip pain. Methods: This was a retrospective review of all patients who underwent hip aspiration for the evaluation of hip pain at a tertiary care children’s hospital in a Lyme endemic area. Clinical and laboratory data were reviewed and comparative analyses were performed between those diagnosed wit...
Source: Journal of Pediatric Orthopaedics - Category: Orthopaedics Tags: Selected Topics Source Type: research
Conclusions: Although septic arthritis of the knee and Lyme monoarthritis share common features that can make them difficult to distinguish clinically, the presence of pain with short arc motion, C-reactive protein of>4.0 mg/L, patient-reported history of fever, and age younger than 2 years were independent predictive factors of septic arthritis in pediatric patients. The more factors that are present, the higher the risk of having septic arthritis. Level of Evidence: Diagnostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Source: JBJS - Category: Orthopaedics Authors: Tags: Infection, Pediatrics Scientific Articles Source Type: research
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