A case report of suppurative acromioclavicular arthritis and literature review
10.3760/cma.j.cn121113-20221103-00648
- VernacularTitle:化脓性肩锁关节炎一例报告及文献复习
- Author:
Jinhua GUO
1
;
Zhibing GONG
;
Jinzhi SU
Author Information
1. 福建中医药大学附属泉州市正骨医院关节科，泉州 362000
- Keywords:
Acromioclavicular joint;
Arthritis, infectious;
Debridement;
Anti-bacterial agents
- From:
Chinese Journal of Orthopaedics
2023;43(9):591-597
- CountryChina
- Language:Chinese
-
Abstract:
One case of suppurative acromioclavicular arthritis caused by Staphylococcus aureuswas reported. The patient was admitted to hospital due to swelling and pain in the right shoulder, limited mobility without no obvious cause.Through medical history, physical examination, imaging examination, and local tissue bacterial culture, it was confirmed that the infection was caused by Staphylococcus aureus. After surgery and anti infection treatment, satisfactory treatment results were achieved. Through literature review, 95 cases of suppurative acromioclavicular arthritis were retrieved and analyzed from 57 articles.Among them, 26 cases (27%) were infected with Staphylococcus aureus, including 3 cases of clearly identified methicillin-resistant Staphylococcus aureus, 2 cases of methicillin-sensitive Staphylococcus aureus, and 1 case of methicillin-resistant Staphylococcus epidermidis; 13 cases (14%) of Streptococcus; There were 6 cases (6%) of special pathogens, including 2 cases of Haemophilus parainfluenzae, 1 case of Candida, 1 case of Bacillus pallidum, 1 case of Mycobacterium avium, and 1 case of Pasteurella multocida; 50 cases (53%) of specific infections with pathogens were not clearly reported. Suppurative acromioclavicular arthritis has the characteristics of difficult early diagnosis, rapid disease progression, and strong destructiveness. MRI and ultrasound have high specificity and sensitivity in the diagnosis of this disease, and ultrasound can assist in obtaining joint fluid for examination. Early identification of the pathogen is the key to the treatment of this disease. Before identifying the pathogen, antibiotics should not be used arbitrarily. After diagnosis, timely anti infection treatment should be carried out, and if necessary, surgical debridement should be performed. The vast majority of patients can achieve satisfactory and accurate treatment results after active and standardized treatment.
