Suppurative arthritis of the hip in children

Morrey, B.F.; Bianco, Angelica; Rühle, KH

doi:10.2106/00004623-197658030-00017

Cited by 98 publications

(76 citation statements)

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“…Children were followed up in the out-patient clinic for a mean period of 23 months (range 14-39) in the arthrotomy group and for a mean period of 21.7 months (range [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] in the arthroscopy group.…”

Section: Resultsmentioning

confidence: 99%

“…The lower age limit for the children to be included in the study was set to be three years to exclude any effect of patient's age on the final outcome [12][13][14][15][16][17][18][19][20]. Most authors agree that neonates and infants are more likely to have unsatisfactory results than children older than three years of age [12,[14][15][16][17][18][19].…”

Section: Methodsmentioning

confidence: 99%

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Treatment of early septic arthritis of the hip in children: Comparison of results of open arthrotomy versus arthroscopic drainage

El-Sayed

2008

Journal of Children's Orthopaedics

122

103

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Purpose The goal of this study was to compare results of open arthrotomy versus arthroscopic drainage in treating septic arthritis of the hip in children. Methods This prospective controlled study was conducted on twenty patients (20 hips) with acute septic arthritis of the hip. Diagnosis was suspected if there was: a history of fever, non-weight-bearing on the affected limb, erythrocyte sedimentation rate (ESR) of at least 40 mm/h, and white blood cell count of more than 12,000 cells per cubic millimeter. Diagnosis was established by ultrasonographic examination of the affected hip followed by ultrasound-guided aspiration of the joint. Patients were allocated to have either open arthrotomy or arthroscopic drainage of the joint. There were ten patients (ten hips) in each treatment group. The mean age of the patients was 7.3 years in the arthrotomy group, and 8 years in the arthroscopy group. The mean temperatures for the arthrotomy and arthroscopy groups were 38.8 and 38.7°C, respectively. All the children were unable to bear weight on the affected limb.Results Staphylococcus aureus was the most common causative microorganism in both groups. The mean duration of the children's hospital stay was 6.4 days in the arthrotomy group and 3.8 days in the arthroscopy group. The difference was highly significant. Infection could be eradicated in all patients of both groups. At the latest follow-up, seven children in the arthrotomy group (70%) had excellent results and three children (30%) had good results. In the arthroscopy group, nine children (90%) had excellent results and one child (10%) had good results. The difference was not statistically significant. Conclusions Arthroscopic drainage is an effective method in treating septic arthritis of the hip. It is a minimal invasive procedure which is associated with less hospital stay. Arthroscopic drainage of septic arthritis of the hip in children is a valid alternative procedure in early uncomplicated cases and for orthopedic surgeons skilled in pediatric arthroscopy.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Treatment of early septic arthritis of the hip in children: Comparison of results of open arthrotomy versus arthroscopic drainage

El-Sayed

2008

Journal of Children's Orthopaedics

122

103

View full text Add to dashboard Cite

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“…Of these, 15 children could be followed up for six months after disease onset. The initial diagnosis of acute osteomyelitis had been made using Peltola and Vahvanen's criteria [8] and of septic arthritis using Morrey et al's criteria [6]; those not meeting the criteria were excluded from the study. Of the 15 children, nine were boys and six were girls.…”

Section: Methodsmentioning

confidence: 99%

“…Osteoarticular infection of the skeletal system in children is a very common problem and increasing day by day in developing countries [2,6]. However, the incidence has declined in developed countries in recent years [5].…”

Section: Introductionmentioning

confidence: 99%

“…Computed tomography does not add much information about the cartilaginous physis [11]. It has only been after the advent of magnetic resonance imaging (MRI) that the physis can now actually be visualised and injuries to the growth plate can be defined in detail [6]. There are studies where within six months after trauma physeal changes were documented on MRI [4,13].…”

Section: Introductionmentioning

confidence: 99%

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Role of MRI in detecting early physeal changes due to acute osteoarticular infection around the knee joint: a pilot study

Wardak¹,

Gill

Wardak³

et al. 2008

International Orthopaedics (SICOT)

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Physeal changes of any aetiology in children are usually diagnosed once the deformity is clinically evident. Between January 2006 and June 2007, 15 children who suffered from acute osteoarticular infection around the knee joint were studied. They were called up for follow-up six months after the onset of infection. All patients were evaluated by clinical and roentgenographic examination before undergoing magnetic resonance imaging (MRI) study of both knees "with the unaffected knee serving as control". Abnormal findings in the physis, metaphysis and/ or epiphysis on MRI were observed in five children. This group of five children was compared with the other ten children for clinical presentation and course of disease. We believe that MRI is a useful tool in the evaluation of growth plate insult in the early period following acute osteoarticular infection, and we can diagnose and prevent the catastrophic complications of the same.Résumé La modification de la physe chez l'enfant, quelle que soit l'étiologie en cause est habituellement diagnostiquée après que la déformation devienne évidente. Entre janvier 2006 et juin 2007, 15 enfants présentant une infection ostéo articulaire aiguë autour du genou ont été étudiés et ont été suivis pendant six mois après le début de l'infection. Les patients ont été évalués de façon clinique et radiographique ainsi qu'avec une étude IRM au niveau des deux genoux, le genou sain servant de contrôle. Des modifications anormales de la physe ou de la métaphyse sur l'IRM ont été observées chez 5 enfants. Ce groupe de 5 enfants est comparé avec l'autre groupe de 10 enfants. Nous espérons que l'IRM sera un examen utile quant à l'évaluation de la lésion précoce de la plaque de croissance avec possibilité d'un diagnostic précoce après une infection ostéo articulaire de façon à prévenir une complication catastrophique.

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Acute staphylococcal septic arthritis: The effect of cloxacillin therpy in an avian model

Patel¹,

Nade²

1988

Journal Orthopaedic Research

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An experimental model of acute staphylococcal septic arthritis in chickens was used to study the effect of different therapeutic regimens of the antibiotic cloxacillin on the natural history of the disease. Three different therapeutic regimens were used in order to assess the effect of increasing the frequency and of delaying the commencement of administration. The results were assessed by measurement of animal growth rate, clinical condition, bacterial and leukocyte counts in synovial fluid, and histological appearance. An inadequate dosage regimen (a single daily dose) prevented spread of bacteria but did not control abscesses. Delay in commencing treatment permitted persistence and spread of abscesses with destruction of the secondary (epiphyseal) ossification center and even transphyseal spread into metaphyseal bone. Repair by fibroblasts was mainly seen in articular and epiphyseal cartilage but was not seen in the epiphyseal ossification center during the duration of the experiments (up to 18 days). Synovial fluid sampling with measurement of leukocyte and bacterial concentrations appears to be a useful guide to the effectiveness of treatment, because the numbers of cells correlate with the pathological process.

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Suppurative arthritis of the hip in children

Cited by 98 publications

References 0 publications

Treatment of early septic arthritis of the hip in children: Comparison of results of open arthrotomy versus arthroscopic drainage

Treatment of early septic arthritis of the hip in children: Comparison of results of open arthrotomy versus arthroscopic drainage

Role of MRI in detecting early physeal changes due to acute osteoarticular infection around the knee joint: a pilot study

Acute staphylococcal septic arthritis: The effect of cloxacillin therpy in an avian model

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