Primary septic arthritis of the acromio-clavicular joint: case report and review of literature

Abstract

Primary septic arthritis of the Acromio clavicular joint is an uncommon disorder and is rarely seen even in an immunocompromised individual. We report a case of primary septic arthritis of the acromio-clavicular (A-C) joint caused by Staphylococcus aureus without any predisposing factors. The patient was admitted with left shoulder pain, restricted movements and fever. Laboratory parameters showed high C-reactive protein, raised erythrocyte sedimentation rate and leucocytosis. Blood cultures were positive for Staphylococcus-aureus. Magnetic resonance imaging (MRI) using Gadolinium enhancement revealed marked effusion in the A-C joint. Aspiration from the A-C joint revealed a heavy growth of Staphylococcus-aureus. The patient was successfully treated with 8 weeks of appropriate antibiotics with complete resolution of infection and return to full function.

Isolation of Coxiella burnetii from an acromioclavicular infection with low serological titres

“…Streptococcus viridans, Streptococcus bovis, and Mycobacterium avium have also been described. Most reports concern patients with an underlying predisposition or suffering from an immunocompromising disease (Iyengar et al, 2009).…”

Pseudogout of the acromioclavicular joint: report of two cases and review of the literature

“…However, septic arthritis of the AC joint may occur in a patient without underlying disease, trauma, injury, or any evidence of immune deficiency [15]. In such cases, differentiation of a pseudogout attack from septic arthritis is quite difficult.…”

Acromioclavicular Joint Disease

“…19 Nevertheless, the absence of specific risk factors does not preclude the diagnosis because cases have been reported in previously healthy individuals. 20 The clinical features of septic arthritis include pain, fever, and tender swelling of the ACJ. Ultrasound may be useful in demonstrating an effusion, and the absence of joint fluid makes septic arthritis unlikely.…”

“…However, in contrast to larger joints, ACJ septic arthritis may resolve following joint aspiration and antibiotics. 20…”