Pediatric facet joint septic arthritis

Acute haematogenous septic arthritis of a lumbar facet joint in an otherwise healthy adolescent

“…Since 1987, only four cases of haematogenous interapophyseal infectious arthritis in paediatric patients have been published in the medical literature, three in lumbar spine: 18 month-old (right L4-L5), 8 year-old (left L5-S1), 10 year-old (left L4-L5) [4][5][6] and one in thoracic spine: 8 year-old (left T11-12) 7 . The first patient presented with a septic pharyngeal infection and the third one with a positive urine culture, while no primary infection was present in the second patient.…”

“…Two children presented with an extradural mass from the lower thoracic area to the sacrum with maximum L4-L5 thecal compression 6 and in T11-12 7 for epidural abscess. Other adult patients reported complications are meningoencephalitis without fever or risk factors 12 , paraspinal abscess 13 , progressive quadriplegia 14 and generalized infection 15 .…”

“…Cases of facet joint septic arthritis, which accounts for 4% of spinal infections with an incidence of 0.2-2/10,000 of overall hospital admissions 2,3 , have on rare occasions been reported as the cause of low back pain. To the authors' knowledge, only four cases in children of facet joint septic arthritis, of probable haematogenous origin, have been previously published [4][5][6][7] .…”

Septic Arthritis of Facet Joint in Children

“…The systematic review (Fig. 1) retrieved 10 articles reporting one pediatric SAFJ each, 3,[8][9][10][11][12][13][14][15][16] (Tables 1 and 2) and 4 selected guidelines [17][18][19][20]…”

“…3). The spine involvement was lumbar (14/16) and 2/16 were thoracic (cases-[ 12 ]- [ 14 ]). The main differential diagnoses were spondylodiscitis and vertebral osteomyelitis; they were ruled out because of a lack of disc space and vertebral body involvement.…”