Septic elbow arthritis in children: Epidemiology and outcome

Kaziz, Hamdi; Triki, Mohamed Amine; Mouelhi, Thabet; Bouattour, Karim; Naouar, Nader; Ayèche, Mohamed Laziz Ben

doi:10.1016/j.arcped.2018.11.001

Cited by 8 publications

(13 citation statements)

References 23 publications

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“…Two studies included patients with septic arthritis of the elbow. 9 , 14 In these studies 29 patients were included with a weighted mean follow-up of 49 months (range, 37–60 months). The study details are described in Table 2 .…”

Section: Resultsmentioning

confidence: 99%

“… 9 Kaziz et al performed a lateral arthrotomy in 15 patients after aspiration identified cases with presumed septic arthritis of the elbow. 14 …”

Section: Resultsmentioning

confidence: 99%

“…Three cases of elbow stiffness were identified; one with concomitant osteomyelitis, one after pinning of a supracondylar fracture, and one with previous extension deficit in concomitant sickle cell disease. 14 Both studies mentioned the duration of symptoms, and Kaziz et al described these data for every individual patient. However, no firm conclusion could me made about the relation between the duration of symptoms and the functional outcome.…”

Section: Resultsmentioning

confidence: 99%

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Aspiration or arthrotomy for paediatric septic arthritis of the shoulder and elbow: a systematic review

et al. 2021

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Upper extremity arthritis in children can be treated with joint aspiration, arthroscopy or arthrotomy, followed by antibiotics. The literature seems inconclusive with respect to the optimal drainage technique. Therefore, the objective of this systematic review was to identify the most effective drainage technique for septic arthritis of the upper extremity in children. Two independent investigators systematically searched the electronic MEDLINE, EMBASE and Cochrane databases for original articles that reported outcomes of aspiration, arthroscopy or arthrotomy for septic arthritis of the paediatric shoulder or elbow. Outcome parameters were clinical improvement, need for repetitive surgery or drainage, and complications. Out of 2428 articles, seven studies with a total of 171 patients treated by aspiration or arthrotomy were included in the systematic review. Five studies reported on shoulder septic arthritis, one study on elbow septic arthritis, and one study on both joints. All studies were retrospective, except for one randomized prospective study. No difference was found between type of treatment and radiological or clinical outcomes. Aspiration of the shoulder or elbow joint required an additional procedure in 44% of patients, while arthrotomy required 12% additional procedures. Conclusion: Both aspiration and arthrotomy can achieve good clinical results in children with septic arthritis of the shoulder or elbow joint. However, the scientific quality of the included studies is low. It seems that the first procedure can be aspiration and washout and start of intravenous antibiotics, knowing that aspiration may have a higher risk of additional drainage procedures. Cite this article: EFORT Open Rev 2021;6:651-657. DOI: 10.1302/2058-5241.6.200122

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Section: Resultsmentioning

confidence: 99%

“… 9 Kaziz et al performed a lateral arthrotomy in 15 patients after aspiration identified cases with presumed septic arthritis of the elbow. 14 …”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Aspiration or arthrotomy for paediatric septic arthritis of the shoulder and elbow: a systematic review

et al. 2021

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“…Finally, periarticular infection may be present in the setting of SA, especially in joints with metaphyseal intra-articular extension (shoulder, elbow, hip, and ankle). 32 33 34 35 36 37 MRI has emerged as the ideal imaging modality to evaluate for adjacent infection; however, there remains some debate about the indications for, or timing of, MRI in the setting of suspected SA. Several studies have proposed guidelines for MRI acquisition, 33 , 37 , 38 whereas other studies recommend all children with suspected SA undergo imaging because of the relative frequency of confirmed contiguous infection.…”

Section: Discussionmentioning

confidence: 99%

Current Variation in Joint Aspiration Practice for the Evaluation of Pediatric Septic Arthritis

Shaw

Sanborn²,

Shore³

et al. 2020

JAAOS Glob Res Rev

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Introduction: Pediatric septic arthritis (SA) is a condition that can be associated with significant morbidity. Although previous research has been on predictive care pathways, scrutiny of the literature continues to reveal wide differences in the patient evaluation and management. The purpose of this study was to define the differences in joint aspiration for the evaluation of pediatric SA across pediatric tertiary care institutions in the United States. Methods: Surgeons from 18 pediatric tertiary care centers across the United States were surveyed on current institutional practices regarding joint aspiration, laboratory studies, MRI usage, and treatment timing in the evaluation for SA. Responses were recorded by institution and analyzed to generate descriptive statistics. Results: Responses were received from all institutions asked to participate. Overall, joint specific practice variation exists regarding the person completing the aspiration, where the aspiration is performed, utilization of image guidance, and the utilization of anesthesia. Additional areas of variation included the method and calculation of cell count and the routine use of MRI. Discussion: Significant practice variations exist across pediatric tertiary care centers for the evaluation of pediatric SA. Using these data, future prospective studies can be used to unify institutional practices to minimize practice variation and ultimately improve the care delivery to pediatric patients presenting with SA.

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“…Typical and common examples are the hip and the shoulder, 6 , 14 , 42 – 45 and elbow. 46 , 47 Typically, AOI occur in children and adolescents who are who present with no co-occurring health problems. 1 – 4 Nevertheless, patients with renal osteodystrophy, haematologic disorders, those receiving regular steroid therapy, acute lymphoblastic leukaemia and juvenile diabetes are considered at high risk for developing AOI.…”

Section: Diagnostic Challengesmentioning

confidence: 99%

Acute osteoarticular infections in children are frequently forgotten multidiscipline emergencies: beyond the technical skills

El-Sobky

Mahmoud

2021

EFORT Open Reviews

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Acute osteoarticular infections (AOI) should be treated as top emergencies. The first few days following the inception of infection are ultra-critical to long-term prognosis. A comprehensive road map for management of childhood AOI is still lacking despite recent advances in microbiology and imaging (magnetic resonance imaging). The many faces of childhood AOI warrant a multidiscipline approach to management. Laboratory and imaging findings of are still debatable and should not overshadow or delay a management plan based on the experienced physician’s clinical judgment. Ample evidence-based practice supports the use of a few days of intravenous antibiotic administration followed by oral therapy until correlative clinical and basic laboratory (acute phase reactants) results improve. The growing body of evidence on ‘high-risk’ children/neonates of AOI warrants continual clinical extra-vigilance in identifying these patient subsets. Open drainage and debridement remain the mainstay of treatment of septic hips, whereas for other joints the use of alternative surgical techniques should be individualized or on case-by-case basis. Because the consequences of misdiagnosis of AOI are usually grave and permanent, proactive treatment/overtreatment is justified in the event of unconfirmed but suspicious diagnosis. Cite this article: EFORT Open Rev 2021;6:584-592. DOI: 10.1302/2058-5241.6.200155

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Septic elbow arthritis in children: Epidemiology and outcome

Cited by 8 publications

References 23 publications

Aspiration or arthrotomy for paediatric septic arthritis of the shoulder and elbow: a systematic review

Aspiration or arthrotomy for paediatric septic arthritis of the shoulder and elbow: a systematic review

Current Variation in Joint Aspiration Practice for the Evaluation of Pediatric Septic Arthritis

Acute osteoarticular infections in children are frequently forgotten multidiscipline emergencies: beyond the technical skills

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