Ultrasound abnormalities in septic arthritis are associated with functional outcomes

Gaigneux, Emeline; Cormier, Grégoire; Varin, Stéphane; Mérot, O.; Maugars, Yves; Goff, Benoît Le

doi:10.1016/j.jbspin.2017.02.002

Cited by 19 publications

(16 citation statements)

References 12 publications

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“…3,4 As more EPs become competent in POCUS, it is now easier to assess a hip joint in more detail, especially for effusion, which by ordinary physical examination alone would be tricky in such a deep structure. However, as exemplified by this case, it is important to keep in mind that effusion, although most well known, is not the only POCUS finding of septic arthritis, 2 and that the manoeuvre of passive internal rotation of the hip may increase the sensitivity of detection of effusion, especially if the amount is small that can pool to the posterior of the joint when the capsule is lax. If the effusion is of a significant volume, ultrasound guided aspiration by an experienced EP is a reasonable option.…”

Section: Discussionmentioning

confidence: 88%

An uncommon disease with an under-recognised finding

Cheung¹,

Kitchell²,

Law³

2019

Hong Kong Journal of Emergency Medicine

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Section: Discussionmentioning

confidence: 88%

An uncommon disease with an under-recognised finding

Cheung¹,

Kitchell²,

Law³

2019

Hong Kong Journal of Emergency Medicine

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“…Imaging studies are an integral part of the management of SA patients. MRI has a very high sensitivity, of nearly 100%, in diagnosing joint effusion, synovitis and bone or cartilage destruction [ 20 ]. Musculoskeletal US provides also a significant diagnostic performance with further advantages regarding availability, low cost and crucial aid in guided fluid aspiration or synovial biopsy [ 21 ].…”

Section: ⧉ Discussionmentioning

confidence: 99%

Staphylococcus aureus-induced septic arthritis of the ankle related to malum perforans in a diabetes patient

Bărbulescu¹,

Firulescu²,

Chisălău³

et al. 2022

Rom J Morphol Embryol

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Septic arthritis (SA) is a less common joint pathology with potentially fatal outcome. It is considered a medical emergency, in which prompt diagnosis and differentiation of bacterial etiology is essential for appropriate management. The knee is the most prevalent site for SA (~50% of cases), followed by hip, shoulder, and elbow. Early intervention requires an accurate diagnosis and imaging techniques enable both a positive diagnosis, as well as arthrocentesis and liquid analysis, the "gold standard" criteria. We report the case of a 70-year-old patient, with history of rheumatoid arthritis (RA), diabetes mellitus (DM) and persistent left malum perforans in the last year, with development of a severe and debilitating Staphylococcus aureus-related SA of the left ankle, which posed significant therapeutic challenges. He developed a plantar lesion at the ball of the left foot, in the past one year, which was labeled as malum perforans in the setting of DM. Musculoskeletal ultrasound was the primary imaging technique used to define the location and extent of the infectious process. Cultures drawn from the tissue were positive for S. aureus. After an antibiotic course, the apparent infectious features were remitted but the long-lasting open wound failed to improve. Antibiotic therapy was initiated in accordance with culture sensibility tests but short-and long-term outcome was unfavorable with both treatment unresponsiveness and comorbidity burden posing considerable difficulties. The association and interrelation between different comorbidities (such as hypertension, diabetes, or obesity), chronic systemic inflammation (e.g., C-reactive protein level, disease activity), and RA medication is sometimes difficult to understand and to address in daily practice, and this case report highlights multiple toils encountered in a SA patient with RA on immunosuppressive therapy and complicated DM.

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“…1c belegt. Sehr selten können mal ein periartikulärer Abszess oder Zeichen einer Weichteilentzündung detektiert werden [9]. Die sonografischen Zeichen einer Kristallarthritis fehlen.…”

Section: Septische Arthritisunclassified

Sonografie in der Rheumatologie

Löffler¹,

Hellmich²

2019

Klinikarzt

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ZUSAMMENFASSUNGDie Sonografie spielt in der rheumatologischen Diagnostik neben Anamnese, körperlicher Untersuchung und Labor eine zentrale Rolle. In der Klinik ermöglicht die rasche Verfügbarkeit der Sonografie eine zeitnahe Diagnostik bei unterschiedlichen Fragestellungen in der Rheumatologie und liefert durch die Möglichkeit dynamischer Untersuchungen zusätzliche Informationen, welche gegebenenfalls andere bildgebende Verfahren ergänzen.Die Arthrosonografie grenzt nicht nur entzündliche von nicht entzündlichen Gelenkpathologien ab, sie ist auch in der Lage, Aussagen über das quantitative Maß der Entzündungsaktivität, den Remissionsstatus einer Erkrankung, das Vorliegen erosiver Knochenveränderungen und in vielen Fällen auch über die ätiologische Einordnung der Entität zu machen. Neben der Beurteilung von Synovia und Bursen erlaubt der muskuloskelettale Ultraschall auch eine Beurteilung von Sehnen und Enthesen.Bei der Diagnostik von Großgefäßvaskulitiden wie der Riesenzellarteriitis ermöglicht der vaskuläre Ultraschall eine direkte Visualisierung der Gefäßwandentzündung und trägt damit entscheidend zur raschen Diagnosestellung und Ausbreitungsdiagnostik bei.Bei der Abklärung von Sicca-Symptomen können über den Nachweis B-Bild-morphologischer Veränderungen des Speicheldrüsenparenchyms Patienten mit primärem Sjögren-Syndrom rasch identifiziert werden.Der rheumatologische Ultraschall ist aus der Diagnostik bei entzündlichen Systemerkrankungen nicht mehr wegzudenken. Die zunehmende Standardisierung von Durchführung, Befunden und Grenzwerten, die durch die Outcome Measures in Rheumatology (OMERACT) Task Force der European League Against Rheumatism (EULAR) vorangetrieben wird, wird in Zukunft zu noch mehr diagnostischer Validität und Vergleichbarkeit beitragen.

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Ultrasound abnormalities in septic arthritis are associated with functional outcomes

Cited by 19 publications

References 12 publications

An uncommon disease with an under-recognised finding

An uncommon disease with an under-recognised finding

Staphylococcus aureus-induced septic arthritis of the ankle related to malum perforans in a diabetes patient

Sonografie in der Rheumatologie

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