A nationwide analysis of failed irrigation and debridement for pediatric septic arthritis of the hip

Irrigation and debridement (I&D) is the gold standard for treatment of pediatric septic arthritis of the hip. If the index surgery fails, subsequent surgery may be required to eradicate the infection, resulting in substantial increases in morbidity, healthcare costs, and psychosocial burden. The purpose of this study was to identify the incidence of failed I&D for pediatric septic arthritis of the hip, defined by the need for at least one subsequent surgical intervention, and potential risk factors for failed initial I&D. The Kids’ Inpatient Database was used to extract data for pediatric patients diagnosed with septic arthritis of the hip from 1997 to 2012. Factors such as patient demographics, preoperative comorbidities, inpatient variables, and hospitals variables were assessed for associations with successful versus failed I&Ds. During the period examined, 3341 (94.3%) children were successfully treated with a single I&D, whereas 203 (5.7%) children required at least one additional surgery during the same hospitalization. Univariate analysis found anemia, coagulopathy, and electrolyte disorders to be associated with repeat surgery. Patients who required multiple surgeries had significantly longer lengths of stay (11.3 vs. 6.9 days), higher likelihood of being discharged with home health (39 vs. 25%), and higher total overall inpatient costs ($58 400 vs. $31 900). On the basis of the results of this study, the nationwide incidence of patients requiring multiple I&Ds ...
Source: Journal of Pediatric Orthopaedics B - Category: Orthopaedics Tags: PELVIS & HIP Source Type: research

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Authors: Semionov A, Kosiuk J, Ajlan A, Discepola F Abstract Identification of certain abnormalities of the chest wall can be extremely helpful in correctly diagnosing a number of syndromic conditions and systemic diseases. Additionally, chest wall abnormalities may sometimes constitute diagnoses by themselves. In the present pictorial essay, we review a number of such conditions and provide illustrative cases that were retrospectively identified from our clinical imaging database. These include pentalogy of Cantrell, Klippel-Feil syndrome, cleidocranial dysplasia, Poland syndrome, osteopetrosis, neurofibromatosis ...
Source: Korean Journal of Radiology - Category: Radiology Tags: Korean J Radiol Source Type: research
Publication date: Available online 16 March 2018Source: International Journal of GerontologyAuthor(s): I-fan Lo, Hao-chiun ChangSummaryJoint infections due to non-typhi Salmonella are rare, and usually associated with sickle cell anemia or other immunosuppressive disorders. An 80-year-old female, with a recent history of lung adenocarcinoma and a 20 year history of rheumatoid arthritis with steroid use, presented with hip pain. Her right hip had 3 screws due to a femoral neck fracture 5 years previously, and she reported suffering from intermittent right hip pain for the previous 3 years. Patrick's test was positive and X-...
Source: International Journal of Gerontology - Category: Geriatrics Source Type: research
Publication date: Available online 16 March 2018 Source:International Journal of Gerontology Author(s): I-fan LoHao-chiun Chang Joint infections due to non-typhi Salmonella are rare, and usually associated with sickle cell anemia or other immunosuppressive disorders. An 80-year-old female, with a recent history of lung adenocarcinoma and a 20 year history of rheumatoid arthritis with steroid use, presented with hip pain. Her right hip had 3 screws due to a femoral neck fracture 5 years previously, and she reported suffering from intermittent right hip pain for the previous 3 years. Patrick's test was positive and X-rays s...
Source: International Journal of Gerontology - Category: Geriatrics Source Type: research
ConclusionThe disease has distinct regional variations, and the epidemiological and bacterial profile is constantly changing. There is a shift in causative organisms towards more resistant and gram-negative species. Prematurity, low birthweight and previous hospitalisation are the major predisposing factors. A better understanding of the varied presentations is necessary for an early diagnosis and treatment, which is the most important prognostic factor.
Source: European Journal of Orthopaedic Surgery and Traumatology - Category: Orthopaedics Source Type: research
AbstractSurface defects have a central position in diagnosis of articular pathology. Recognizing the limitations of standard radiologic techniques and those imposed by positioning and averaging artifacts on CT evaluation, direct visualization of surface defects was pursued to identify disease characteristics that would facilitate interpretation of radiologic findings. Epi-illumination surface microscopy was utilized to examine macroscopically recognized articular surface defects in individuals in the Hamann-Todd, Terry, and Huntington human skeletal collections with previously verified diagnoses of rheumatoid arthritis, sp...
Source: Clinical Rheumatology - Category: Rheumatology Source Type: research
Authors: Vanderhave KL, Perkins CA, Scannell B, Brighton BK Abstract Sickle cell disease (SCD) is an autosomal recessive disorder that results in hemolytic anemia related to abnormal hemoglobin and erythrocyte levels. SCD is characterized by vascular occlusive episodes, visceral sequestration, and aplastic or hemolytic crises. These crises most commonly occur in bone. The orthopaedic manifestations of SCD comprise much of the morbidity associated with this disorder. Osteonecrosis and osteomyelitis are among the most disabling and serious musculoskeletal complications in patients with SCD. Effective management of th...
Source: The Journal of the American Academy of Orthopaedic Surgeons - Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research
Conclusion Our case series highlights the possibility of salmonella typhi osteomyelitis in immunocompetent individuals. Clinicians should be aware of this presentation which is usually delayed due to the atypical organism and lack of clinical response in the initial stages, as disastrous sequelae of septic arthritis may result if prompt treatment is not initiated in time.
Source: Journal of Clinical Orthopaedics and Trauma - Category: Orthopaedics Source Type: research
In conclusion, S.capitata infections should be taken into consideration in the presence of fungemia and septic arthritis in hematological patients who receive caspofungin therapy. PMID: 28283014 [PubMed - in process]
Source: Mikrobiyoloji Bulteni - Category: Microbiology Tags: Mikrobiyol Bul Source Type: research
This report was aimed to draw attention to the accurate identification of P.luteola in clinical samples, upon the isolation and identification in two cases in the medical microbiology laboratory of a university hospital. In February 2011, a 66-year-old man, with chronic obstructive pulmonary disease, coronary artery disease and aplastic anemia, was admitted to our hospital due to progressive dyspnea. A chest tube was inserted on the 20th day of admission by the reason of recurrent pleural effusion. Staphylococcus aureus and a non-fermentative gram-negative bacillus (NFGNB) with wrinkled, sticky yellow colonies were isolate...
Source: Mikrobiyoloji Bulteni - Category: Microbiology Tags: Mikrobiyol Bul Source Type: research
Conclusion Prematurity and anemia still appear to be important risk factors for neonatal septic arthritis. As there is changing trend toward gram-negative infections, attention has to be given toward preventing nosocomial and community-acquired infections. This is very important in premature infants who are susceptible for infection when they are kept in resuscitative units in hospitals.
Source: European Journal of Orthopaedic Surgery and Traumatology - Category: Orthopaedics Source Type: research
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