Acute Haematogenous Osteomyelitis and Septic Arthritis in Childhood:<i>A 10-Year Review and Follow-Up</i>

Petersen, Sten; Knudsen, Finn Ursin; Andersen, Erik Arthur; Egeblad, M

doi:10.3109/17453678008990822

Cited by 60 publications

(23 citation statements)

References 16 publications

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“…[3][4][5] Occasionally, a limp in a child can be an early manifestation of a serious condition such as septic arthritis or neoplasm, resulting in long-term complications if the diagnosis is delayed. [6][7][8][9] Inflammatory serum parameters including ESR, CRP and WBC counts may be slightly elevated in TS; although, raised inflammatory markers are also strong predictors of more severe conditions such as septic arthritis. 9 Differentiating septic arthritis from TS is a usual practice in PED.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Patients Presenting to a Pediatric Emergency Department with Acute Limping

Şahin¹

2017

cayd

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Introduction:Limping is a common presenting complaint to a pediatric emergency department among children. The differential diagnosis of acute limp includes transient synovitis, trauma, infections, neoplasia, and congenital neuromuscular and developmental disorders. We aimed to evaluate patients presenting with acute limp to our pediatric emergency department and to analyze the clinical characteristics of the disease. In addition, we aimed to investigate the value of several laboratory parameters in early identification of septic and aseptic conditions. Methods: We retrospectively analyzed children under 18 years of age who were admitted to our emergency department with acute limping in a two-year period. Patients with any chronic diseases, any history of trauma, coagulopathy (as documented by blood clotting tests) and any history of intramuscular injections within the previous week were excluded. The patients' complete blood count, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) levels, plain pelvic radiographs and ultrasonography reports were evaluated. The patients were classified as septic or aseptic according to their white blood cells (WBC), CRP and ESR values. Totally 120 patients were included in the study. The upper limit for WBC, ESR and CRP was accepted as 9000 cells/mm 3 , 20 mm/h and 0.8 mg/dL, respectively. Results: Of the total of 86 patients in the aseptic group, 81 had normal WBC, ESR and CRP levels and were diagnosed with transient synovitis, 2 female patients received the diagnosis of slipped upper femoral epiphysis, and 3 patients were diagnosed with Legg-Calvé-Perthes disease during clinical follow-up. The remaining 34 patients with high ESR, WBC and CRP levels were included in the septic group in whom the following diagnoses were established during the follow-up: septic arthritis (n=12), Familial Mediterranean Fever (n=4), juvenile rheumatoid arthritis (n=4), GuillainBarré syndrome (n=3), osteomyelitis (n=3), acute rheumatic fever (n=3), spondyloarthritis (n=3) and Ewing sarcoma (n=2). There was a significant difference in CRP and WBC values between the septic and the aseptic groups, but no significant difference was found in ESR values. Conclusion: Acute atraumatic limp is a commonly encountered condition in children presenting to pediatric emergency departments. Transient synovitis is the most common cause of limping. CRP and WBC are two sensitive markers for diagnosing infectious and malignant etiology in this group of children. Keywords: Child, limping, acute Amaç: Aksama çocuklarda yaygın bir acil servise başvuru nedenidir. Normal yürüyüş paternine göre asimetrik bir tarz oluşması şeklinde tanımlanabilir. Ayırıcı tanısında geçici sinovit, travma, enfeksiyon, tümör veya enflamatuvar nedenler, doğuştan nöromusküler hastalıklar veya gelişimsel bozukluklar düşünülmelidir. Bu çalışmada çocuk acil servisine ani gelişen aksama ile başvuran hastaların sonuçlarını değerlendirmeyi ve bulgularımıza göre hastaların tanı ve takip açısından bazı ipuçları elde etmeyi planlayıp, septik v...

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Section: Discussionmentioning

confidence: 99%

Analysis of Patients Presenting to a Pediatric Emergency Department with Acute Limping

Şahin¹

2017

cayd

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“…15,22,[44][45][46][47][48][49][50] Many authors, however, are divided on the best way to drain the shoulder in children. Some recommend aspiration for all septic shoulders and some arthrotomy.…”

Section: Discussionmentioning

confidence: 99%

Septic arthritis of the shoulder in children in Malawi

Smith

Thyoka

Lavy

et al. 2002

The Journal of Bone and Joint Surgery. British volume

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e undertook a prospective study of 61 children in Malawi with septic arthritis of the shoulder. They were randomised into two groups, treated by aspiration (group 1, 31 patients) or arthrotomy (group 2, 30 patients). Both received antibiotics for six weeks. We studied the results of blood tests, microbiology, and the clinical and radiological outcome one year after diagnosis. Only one patient was sickle-cell positive and three were HIV-positive. Non-typhoidal Salmonella species accounted for 86% (19/22) of the positive joint cultures in group 1 and 73% (16/22) in group 2. Of the 33 radiographs available for review at follow-up at six months, 23 (70%) showed evidence of glenohumeral damage. There was no statistical difference in radiological outcome for the two groups. We devised and validated a scoring system, the Blantyre Septic Joint Score, for the assessment of joints based upon swelling, tenderness, function and range of movement. Despite the radiological changes only one of the 24 joints examined at one year had any deficit in these parameters. There was no statistical difference in the clinical outcome for the two treatment groups at any stage during the period of follow-up.

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“…4,6,[17][18][19] Although the method of drainage is a controversial point between the medical and surgical literature, both agree that septic arthritis of the hip joint requires open surgical drainage. 7,20,21 In this study, three of the four patients who developed permanent damage to the hip joint had needle aspiration as the only mode of drainage.…”

Section: Discussionmentioning

confidence: 99%

Nongonococcal Septic Arthritis at a Major Teaching Hospital in Riyadh, Saudi Arabia

Al-Ballaa

1995

Ann Saudi Med

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Twenty five (25) consecutive cases of nongonococcal septic arthritis admitted to King Khalid University Hospital were retrospectively reviewed. The patients were mostly adults (64%) and Staphylococcus aureus was the most common bacterial species isolated (69%). Predisposing factors were identified in 52% of patients, including diabetes mellitus in seven patients, pre-existing joint disease in two patients and the infection followed intraarticular steroid injections in two patients. All patients were treated with appropriate antibiotics; however, 11 (44%) patients were left with permanent joint damage.

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Acute Haematogenous Osteomyelitis and Septic Arthritis in Childhood:A 10-Year Review and Follow-Up

Cited by 60 publications

References 16 publications

Analysis of Patients Presenting to a Pediatric Emergency Department with Acute Limping

Analysis of Patients Presenting to a Pediatric Emergency Department with Acute Limping

Septic arthritis of the shoulder in children in Malawi

Nongonococcal Septic Arthritis at a Major Teaching Hospital in Riyadh, Saudi Arabia

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