Septic arthritis of the hip is rarely caused by Mycoplasma hominis. It rarely develops in a patient during the postpartum period. However, delayed treatment of septic arthritis of the hip may lead to serious sequelae; therefore, it is important for clinicians not to overlook patients with the disease. This case illustrates the clinical steps in diagnosis and treatment of M. hominis septic arthritis of the hip.
Arthritis, Infectious* ; Diagnosis ; Hip* ; Humans ; Mycoplasma hominis* ; Postpartum Period*

Osteomyelitis of the patella is a very uncommon condition that occurs mostly in the pediatric population. In addition to its rarity, nonspecific and variable clinical presentations usually lead to postponement in making the correct diagnosis. Moreover, it is often missed as prepatellar bursitis or septic arthritis of the knee. Nonetheless making early diagnosis and initiating prompt treatment is most important to preventing this condition from becoming chronic. In this case report, the authors encountered this rare condition of the patella in a child that was first misdiagnosed with pyogenic arthritis or prepatellar bursitis of the knee. The delay in making the diagnosis led to intractable progression of the disease, and sequestrectomy was required to stabilize the condition.
Arthritis ; Arthritis, Infectious ; Bursitis ; Child* ; Diagnosis ; Early Diagnosis ; Humans ; Knee ; Osteomyelitis* ; Patella

Since last August, 29 cases of synovial punch biopsy have been carried out with Franklin-Silverman needle which was used in liver biopsy, instead of the specialized needle for the synovium. Authors report the applicable utility of Franklin-Silverman needle for the synovial biopsy, diagnostic value of this procedure and histopathologic findings of the results. The rate of the technical success to abtain synovial tissue was about 76%. Complications after procedure have been very rarely encountered, consisting of mild transient hemarthrosis. In 17 cases, the histopathologic changes was compatible with their clinical findings. In the remainders, we experienced the failures to get synovial tiasue at all in 7 cases and to give the significant synovial changes in 5 successful specimens. Fortunately, the important diagnostic aid was achieved in 3 cases which were conformed early diagnosis of tuberculous arthritis. This needle biopsy was also thought to contribute to rule out the gouty arthritis from other hyperuricemic conditions. But the histologic changes were non specific inflammatory findings in the synovial mambrane of rheumatoid arthritis, osteoarthritis, traumatic and infectious arthritis.
Arthritis ; Arthritis, Gouty ; Arthritis, Infectious ; Arthritis, Rheumatoid ; Biopsy ; Biopsy, Needle ; Early Diagnosis ; Hemarthrosis ; Liver ; Needles ; Osteoarthritis ; Synovial Membrane

Gout occurs as a response to monosodium urate crystal, that is present in joints, bones and soft tissue. The classic symptoms of gouty arthritis are recurrent attacks of acute, markedly painful monoarticular or oligoarticular inflammation; but polyarthritis and chronic arthritis can also occur. Differential diagnosis from infectious arthritis is important. A definitive diagnosis requires the direct identification of urate crystals in the joint, and the exclusion of infection. We report the case of systemic inflammatory response syndrome (SIRS), developed from acute polyarticular gout. SIRS is characterized by loss of local control of inflammation, or an overly activated response resulting in an exaggerated systemic response. The SIRS was presumably due to systemic effects of a localized inflammatory response to urate crystals.
Arthritis ; Arthritis, Gouty ; Arthritis, Infectious ; Diagnosis, Differential ; Gout ; Inflammation ; Joints ; Sepsis ; Systemic Inflammatory Response Syndrome ; Uric Acid

Acute infections of bone and joints is a curable condition and the chance of cure is related to a number of factors like type and virulence of the organism, resistance of the host, choice of antibiotics, early drainage of the joint in septic arthritis and appropriate treatment after early diagnosis with adequate dosage and duration of antibiotic therapy. Late diagnosis and inadequate treatment can often lead to high mortality and morbidity and leave the patient with crippling sequelae like chronic osteomyelitis, joint destruction, pain, shortening, deformity and limp.
Acute Disease ; Arthritis, Infectious ; complications ; diagnosis ; therapy ; Humans ; Osteomyelitis ; complications ; diagnosis ; therapy ; Suppuration

Acute hematogenous osteomyelitis adjacent to hip, though uncommon, should be included in the differential diagnosis of the patients presenting symptoms suggestive of septic arthritis of hip. When it occurs in children, it is particularly serious, because the diagnosis at first may be very difficult to be made. Our observations on seven cases reported here suggest the following findings to be helpful for early differential diagnosis of osteomyelitis of innominate bones from septic hip. 1. Among 7 cases, 4 had lesions in ischium, and 3 in os ilii. 2. The initial diagnosis on admission in 3 cases out of 7 was wrongly made to be septic arthritis of hip. 3. Early accurate diagnosis is essential to initiate early treatment, and there by shortens the convalescent time and minimize sequelae. 4. The diagnosis could be made in the cases by clinical and roentgenographic findings, such as fever, pain nature, antalgic posture of hip together with range of hip motion, tender point around hip and positive soft tissue and bony X-ray findings, but K-ray taken on early stage of infection could not provide any clue until bone lesion appears. 5. Gentle passive motion of hip is more easily permitted without eliciting severe pain and restriction of motion in the infection of innominate bone than in the septic hip. This also can be another clue to differentiate the acute osteomyelitis of innominate bone from septic arthritis of the hip.
Arthritis, Infectious ; Child ; Diagnosis ; Diagnosis, Differential ; Fever ; Hip ; Humans ; Ischium ; Osteomyelitis ; Pelvic Bones ; Posture

The value of the bone scan in pyogenic bone and joint infections is demonstrated in patients who had signs and symptoms suggestive of bone or joint infection. Nineteen patients were evaluated with 99m Tc-methylene diphosphonate bone scan and roentgenogram. The diagnosis of acute osteomyelitis was made in eight patients, chronic osteomyelitis in six patients, septic arthritis in three patients and two patients had soft tissue infection only. Seven of the eight patients with acute osteomyelitis had focal increase of radiopharmaceutical uptake in the bone well before the bony change appeared on roentgenogram. Five of six chronic osteomyelitis patients had not only bony change on roentgenogram but also increased radiopharmaceutical uptake of bone. But the remaining one had only the former, and the lesion was interpreted as inactive. In two of three septic arthritis patients, the lesion was in S-I joint and both of them had no abnormality on roentgenogram but had increased uptake of radiopharmaceutical agent in the joint. Two patients with soft tissue infection had no abnormal radiological bony change and no increase of the radiopharmarceutical uptake in bone on bone scan. From the above data, we concluded that bone scan is recommended in the evaluation of the patients with signs and symptoms suggestive of bone or joint infection for the earlier diagnosis and differential diagnosis in acute case and for the determination of the activity and location of the lesion in chronic case.
Arthritis, Infectious ; Diagnosis ; Diagnosis, Differential ; Humans ; Joints ; Osteomyelitis ; Soft Tissue Infections

Juvenile idiopathic arthritis (JIA) is a broad spectrum of disease defined by the presence of arthritis of unknown etiology, lasting more than six weeks duration, and occurring in children less than 16 years of age. JIA encompasses several disease categories, each with distinct clinical manifestations, laboratory findings, genetic backgrounds, and pathogenesis. JIA is classified into seven subtypes by the International League of Associations for Rheumatology: systemic, oligoarticular, polyarticular with and without rheumatoid factor, enthesitis-related arthritis, psoriatic arthritis, and undifferentiated arthritis. Diagnosis of the precise subtype is an important requirement for management and research. JIA is a common chronic rheumatic disease in children and is an important cause of acute and chronic disability. Arthritis or arthritis-like symptoms may be present in many other conditions. Therefore, it is important to consider differential diagnoses for JIA that include infections, other connective tissue diseases, and malignancies. Leukemia and septic arthritis are the most important diseases that can be mistaken for JIA. The aim of this review is to provide a summary of the subtypes and differential diagnoses of JIA.
Arthritis ; Arthritis, Infectious ; Arthritis, Juvenile* ; Arthritis, Psoriatic ; Child ; Connective Tissue Diseases ; Diagnosis ; Diagnosis, Differential* ; Genetic Background ; Humans ; Leukemia ; Rheumatic Diseases ; Rheumatoid Factor ; Rheumatology

Gout is one of the most common inflammatory arthritidies in men and postmenopausal women. It causes recurrent and severe pain in the affected joints, especially in the first metatarsophalangeal joint. The stages of gout are divided into asymptomatic hyperuricemia, acute intermittent arthritis with intercritical period and chronic tophaceous gout. It also affects kidney and causes nephrolithiasis and urate nephropathy. Gout can be diagnosed by confirming monosodium urate crystals in the joint fluid through polarizing microscope. In some cases, clinical diagnosis can be made based on the typical features of the attacks. Differential diagnosis from infectious arthritis is important.
Arthritis ; Arthritis, Infectious ; Diagnosis, Differential ; Female ; Gout ; Humans ; Hyperuricemia ; Joints ; Kidney ; Male ; Metatarsophalangeal Joint ; Nephrolithiasis ; Uric Acid

Arthroscopic synovectomy is a widely-used method to treat septic knee arthritis. To date, many authors have reported minimal complications related to arthroscopic treatment, especially vascular injuries. A three-dimensional computed tomography angiography revealed a pseudoaneurysm that arise from the popliteal artery near the arthroscopic site in septic arthritis patients with atherosclerosis and neurofibromatosis. A careful arthroscopic procedure via the posteromedial or posterolateral portal is recommended for the prevention of this complication. We, therefore, recommend close observation after arthroscopic procedure, despite the occurrence of complications; nonetheless, early diagnosis and treatment are important. We report a case of pseudoaneurysm of the popliteal artery with a complicating arthroscopic synovectomy in septic arthritis with literature review.
Aneurysm, False ; Angiography ; Arthritis ; Arthritis, Infectious ; Arthroscopy ; Atherosclerosis ; Debridement ; Early Diagnosis ; Humans ; Knee ; Methods ; Neurofibromatoses ; Popliteal Artery ; Vascular System Injuries