Arthroscopic Removal of an Intra-Articular Migrating Plant Awn Associated with Septic Shoulder Joint Arthritis in a Dog

Abstract

Objective The aim of this study was to describe the clinical presentation, advanced imaging findings and outcomes of arthroscopic treatment of a bacterial septic shoulder arthritis caused by the penetration of a migrating plant awn in a dog. Case Report A 10-month-old, 11 kg, sexually intact male Cocker Spaniel was diagnosed with septic arthritis of the right scapulohumeral joint. Computed tomography revealed marked articular effusion and thickening of the capsule of the right shoulder joint. Ultrasound of the shoulder identified a bilinear hyperechoic structure located within the joint consistent with a plant (grass) awn. Arthroscopy was used for foreign body removal. Antibiotic treatment was prescribed according to bacteriologic sensitivity tests. Treatment was successful: the dog completely recovered and under high levels of activity showed neither clinical signs nor recurrence of lameness on follow-up at 6 and 24 weeks after surgery. Conclusion Migrating plant awn can be the cause of septic arthritis in a dog. The combination of advanced imaging techniques and arthroscopy allowed accurate diagnosis, reduced the risk of surgical complications and shortened recovery time in this patient. Considering the benefits of minimally invasive techniques, arthroscopy represents an excellent option for the treatment of dogs with similar intra-articular foreign bodies.

Bacterial infective stifle arthritis secondary to a migrating grass seed foreign body in an adult dog

“…Grass seeds foreign bodies have been reported as causing disease in a number of diverse anatomical locations including the thorax, nasal cavity, ear, head, neck, penis, vagina, spine, shoulder and epidural space 1,4,9,15,16 . To the authors’ knowledge, this is the first report of a grass seed migrating to the stifle.…”

“…Arthroscopic removal of grass seed from the shoulder joint has been reported recently and was considered in this case. 9 There is evidence that arthroscopy is more sensitive at detecting intra-articular pathology compared to arthrotomy, with meniscal tears associated with cranial cruciate ligament disease being detected more effectively via arthroscopy. 22 Arthroscopy may have allowed a minimally invasive thorough examination of the stifle joint in this case.…”

“…A number of reports have documented bacterial infective arthritis secondary to a penetrating foreign body 5–9 . In addition, bacterial infective arthritis can also occur secondary to haematogenous spread and following surgical contamination 6 …”

Retrospective evaluation of 103 cases of septic arthritis in dogs

“…Bacterial contamination of synovial fluid can occur via direct penetration (surgical, traumatic, migrating foreign body), haematogenous spread or local spread from adjacent tissues. [1][2][3][4][5][6] It typically presents as a monoarthropathy resulting in lameness, swelling, pain and reduced mobility of the affected joint. [5][6][7][8] Systemic signs of illness such as anorexia, pyrexia or lethargy are typical in only a third of patients with SA.…”

“…1 Similarly, arthrotomy or arthroscopy may be indicated to remove the nidus of infection in cases of intraarticular foreign bodies. 3,4 Long-term prognosis and recurrence in dogs with SA is largely unknown. 1,7,8,11 Cases of SA documented between 2019 and 2002 from five veterinary orthopaedic referral practices were reviewed.…”