Subtalar Joint Septic Arthritis in a Patient with Hypogammaglobulinemia

Wynes, Jacob; Harris, William S.; Hadfield, Robert A.; Malay, D. Scot

doi:10.1053/j.jfas.2012.10.012

Cited by 13 publications

(6 citation statements)

References 36 publications

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“…This indicates that sepsis in general seems to be associated with physical conditions beyond joint infection. Comorbidity, for example, associated with drug abuse or immunosuppression, which was not decisive in the course of joint infection, seems to play a more important role in these patients [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Prospective Clinical Trial for Septic Arthritis: Cartilage Degradation and Inflammation Are Associated with Upregulation of Cartilage Metabolites

Schmal

Bernstein

Feucht

et al. 2016

Mediators of Inflammation

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Background. Intra-articular infections can rapidly lead to osteoarthritic degradation. The aim of this clinical biomarker analysis was to investigate the influence of inflammation on cartilage destruction and metabolism. Methods. Patients with acute joint infections were enrolled in a prospective clinical trial and the cytokine composition of effusions (n = 76) was analyzed. Characteristics of epidemiology and disease severity were correlated with levels of cytokines with known roles in cartilage turnover and degradation. Results. Higher synovial IL-1β concentrations were associated with clinical parameters indicating a higher disease severity (p < 0.03) excluding the incidence of sepsis. Additionally, intra-articular IL-1β levels correlated with inflammatory serum parameters as leucocyte counts (LC) and C-reactive protein concentrations (p < 0.05) but not with age or comorbidity. Both higher LC and synovial IL-1β levels were associated with increased intra-articular collagen type II cleavage products (C2C) indicating cartilage degradation. Joints with preinfectious lesions had higher C2C levels. Intra-articular inflammation led to increased concentrations of typical cartilage metabolites as bFGF, BMP-2, and BMP-7. Infections with Staphylococcus species induced higher IL-1β expression but less cartilage destruction than other bacteria. Conclusion. Articular infections have bacteria-specific implications on cartilage metabolism. Collagen type II cleavage products reliably mark destruction, which is associated with upregulation of typical cartilage turnover cytokines. This trial is registered with DRKS00003536, MISSinG.

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Section: Discussionmentioning

confidence: 99%

Prospective Clinical Trial for Septic Arthritis: Cartilage Degradation and Inflammation Are Associated with Upregulation of Cartilage Metabolites

Schmal

Bernstein

Feucht

et al. 2016

Mediators of Inflammation

View full text Add to dashboard Cite

show abstract

“…Moreover, septic arthritis has a predilection for larger joints of the lower extremities like hip or knee, with less common involvement of the ankle or subtalar joints 5. Wynes et al 5 have reported a case of subtalar septic arthritis caused by Mycoplasma hominis in a patient with hypogammaglobulinaemia providing brief overview of its pathogenesis.…”

Section: Discussionmentioning

confidence: 99%

Destructive post-traumatic chondrolysis of the subtalar joint: a case report and review of the literature

et al. 2013

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Injuries to the subtalar joint are often associated with fractures of the talus or calcaneum. These injuries often lead to degenerative changes resulting in pain, restriction of movement and difficulty in weight bearing. This can cause significant deformity and disability for the patient. Occult injury of the subtalar joint has been described as an isolated event or in association with a subluxation/dislocation of this joint. They are difficult to assess with plain radiography therefore, they are generally diagnosed with advanced imaging like CT scan or MRI scan. We present a case of a 66-year-old man who presented with destructive chondrolysis of the subtalar joint 2 years following conservative treatment of a minimally displaced distal fibular fracture. It was treated by subtalar and talonavicular arthrodesis. Overall, the patient made an excellent recovery and was satisfied with the outcome.

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“…Advanced imaging such as computed tomography (CT), magnetic resonance imaging (MRI), ultrasonography (US), and radionucleotide scans, may also be utilized to further strengthen a diagnosis and aid in a treatment plan. 5 Overall treatment for septic arthritis consists of antibiotic therapy and surgical drainage of any purulence and infected tissue. Immediately, empirical antibiotic therapy should be given against the most likely organism based on the clinical history and patient's exposure history.…”

Section: Introductionmentioning

confidence: 99%

“…Although any organism can cause septic arthritis, Staphylococcus aureus is the most common organism cultured, accounting for 55% of cases. 5 Elimination of purulence and infectious material can be done by arthrotomy, arthroscopy, or an open procedure for joints that are difficult to drain. When it comes to the foot and ankle, arthroscopy is becoming the more widely used method in the treatment of joint sepsis due to its rapid recovery and low morbidity.…”

Section: Introductionmentioning

confidence: 99%

“…When it comes to the foot and ankle, arthroscopy is becoming the more widely used method in the treatment of joint sepsis due to its rapid recovery and low morbidity. 5 Bofelli and Thompson discuss in their case report that multiple studies have favored the immediate evacuation of purulent material arthroscopically, pointing out the potential catastrophic effects of joint sepsis versus the low potential risk of an arthroscopic procedure. 6 Arthroscopy also gives the physician direct visualization to examine the joint space and assure all adhesions, purulent pockets, and necrotic tissue are removed.…”

Subtalar Joint Septic Arthritis in a Patient with Hypogammaglobulinemia

Cited by 13 publications

References 36 publications

Prospective Clinical Trial for Septic Arthritis: Cartilage Degradation and Inflammation Are Associated with Upregulation of Cartilage Metabolites

Prospective Clinical Trial for Septic Arthritis: Cartilage Degradation and Inflammation Are Associated with Upregulation of Cartilage Metabolites

Destructive post-traumatic chondrolysis of the subtalar joint: a case report and review of the literature

Polyarticular septic arthritis in the foot and ankle: A unique case report

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