Report of an Uncommon Cluster of Septic Arthritis of the Hip in Premature Newborns: Three Cases in a Period of 3 Months

Abstract

We report an uncommon cluster of this rare condition which occurred within a very short period of time in our unit. We reviewed the current literature and observed that the diagnosis is often delayed, which can have very serious consequences for the outcome. Our 3 patients have had an uncomplicated course so far and follow-up examination at almost one year was normal. A high index of suspicion for the diagnosis and early and aggressive treatment is necessary.

False-negative joint aspiration of septic arthritis of the hip in neonates

“…Velkes et al [15] reported two cases of negative arthrosonograms that were caused by spontaneous capsular perforation and extra-articular drainage of the effusion. Kaczala et al [13] described similar cases in neonates, in whom effusion was absent because the capsule was destroyed. Since our results are based on cases in which aspiration was performed 2-24 days after symptom onset, results varied from cases diagnosed in the very early stages of disease.…”

“…Kaczala et al . [13] described similar cases in neonates, in whom effusion was absent because the capsule was destroyed. Since our results are based on cases in which aspiration was performed 2–24 days after symptom onset, results varied from cases diagnosed in the very early stages of disease.…”

“…Despite the diagnostic utility of joint aspiration, the effusion itself might be absent or too small to detect in a septic joint. In such cases, false-negative findings have been reported [13][14][15]. This unusual situation can misinform decision-making and lead to a delay in appropriate treatment.…”

“…This unusual situation can misinform decision-making and lead to a delay in appropriate treatment. In neonates, however, there are few reports that describe this situation, and no descriptions of the long-term results of such cases [13,[16][17][18][19].…”