Septic arthritis is a surgical emergency. Prompt diagnosis and immediate treatment reduce the destruction of articular cartilage and give better outcome. We describe a simple, minimally invasive closed tube irrigation system for the initial treatment of septic arthritis of the knee in a patient with complex medical problems who was unfit to undergo surgery.
Arthritis, Infectious

The osteomyelitis and arthritis are common surgical emergency. During 10 years(from 1988 to 1997) we operated 214 cases with 143 males and 71 females with Haematogenous osteomyelitis by technique of drilling bone and irrigation of antibiotic solution, surgical drainage of subperiosteal pus. The purpose of those papers are to evaluate method of drilling bone with irrigation of the medullar canal by antibiotic solution and to examine some early signs of osteomyelitis in children. 115 patients were operated by drilling bone with irrigation of antibiotic solution, and 69 patients of them were operated by drainage of subperiosteal pus. The early signs of heamatogenous osteomyelitis with fever, localized paint, swelling, tenderness and warm are usual.
Arthritis, Infectious ; Child

No abstract available.
Arthritis, Infectious* ; Knee*

No abstract available in English.
Arthritis, Infectious ; Dislocations ; Hip

PURPOSE: The purpose of this study was to define the factors affecting results in acute septic hip arthritis in children and to reduce the complications. MATERIALS AND METHODS: This is a retrospective study of 27 children with 28 hip joint infections, treated with arthrotomy and followed up for more than 12 months. Results were evaluated according to Merle D'Aubigne's clinical grade and Bennett's radiological grade, and correlated with the time between symptom onset and treatment, the existence of a causative organism, its species, concomitant osteomyelitis, age of onset and normalized time of C-reactive protein (CRP). We analysed results using the Pearson Chi Square method. RESULTS: A delay in treatment, concomitant osteomyelitis of the proximal femur and old age, were factors associated with poor prognosis. Normalized time of CRP, the existence of a causative organism and species were not correlated with the treatment results. CONCLUSION: Shorter duration of disease from clinical onset to the initiation of therapy and concomitant osteomyelitis of the proximal femur are the most important factors in the treatment of acute septic hip arthritis in children. When analysing results correlated with the age of onset, precise prospective study is required in many cases of acute septic hip arthritis in children.
Age of Onset ; Arthritis ; Arthritis, Infectious* ; C-Reactive Protein ; Child* ; Early Diagnosis ; Femur ; Hip Joint* ; Hip* ; Humans ; Osteomyelitis ; Prognosis ; Retrospective Studies

No abstract available.
Arthritis, Infectious* ; Hip Joint* ; Hip*

We report a patient with reactive arthritis induced by recent streptococcal infection. A 27 year man had suffered from fever, sore throat and pain on left sternoclavicular joint. Arthritis occurred two days after tonsillitis and involved left sternoclavicular joint. Left sternoclavicular joint showed redness, swelling and tenderness. There were no growth of microorganism in blood cultures, no evidence of group Abeta-streptococcus in throat cultures, but antistreptolysin-O (ASO) and c-reactive protein (CRP) serum titers were elevated in sequential monitoring. Bone scan showed focal hot uptake at left sternoclavicular joint and Gallium scan showed diffuse inflammation at left sternoclavicular joint and soft tissue biopsy around sternoclavicular joint showed mild chronic inflammation. We suspected septic arthritis and prescribed empirical antibiotics but his symptoms were wax and wane. From the poor responsiveness to antibiotics, sustained high titers of ASO and recent history of tonsillitis, we confirmed poststreptococcal reactive arthritis, and attempted high-dose anti-inflammatory drug (aspirin 6 gram). Left sternoclavicular and shoulder pain improved.
Anti-Bacterial Agents ; Arthritis ; Arthritis, Infectious ; Arthritis, Reactive* ; Biopsy ; C-Reactive Protein ; Fever ; Gallium ; Humans ; Inflammation ; Palatine Tonsil ; Pharyngitis ; Pharynx ; Shoulder Pain ; Sternoclavicular Joint* ; Streptococcal Infections ; Tonsillitis

Patients with systemic lupus erythematosus(SLE) are at increased risk for infection. Insufficiency of the reticuloendothelial system caused by either immunosuppressive therapy or inadequate opsonization is the mechanism that Salmonella infections in particular appear in these patients. Salmonella infections can provoke a polyarticular reactive arthritis while septic arthritis caused by Salmonella is monoarticular. We report a rare case of septic arthritis caused by Salmonella Group D in a patient with systemic lupus erythematosus. A 20-year-old female patient with systemic lupus erythematosus admitted with a painful swelling of right knee joint. The culture of synovial fluid obtained by aspiration yielded growth of Salmonella Group D. With trimethoprimsulfamethoxazole, the patient was recovered completely.
Arthritis, Infectious* ; Arthritis, Reactive ; Female ; Humans ; Knee Joint ; Lupus Erythematosus, Systemic* ; Mononuclear Phagocyte System ; Salmonella Infections ; Salmonella* ; Synovial Fluid ; Young Adult

PURPOSE: This study analyzed the treatment effects of drain insertion in the posteromedial portal after an arthroscopic synovectomy and posterior septum resection for pyogenic arthritis. MATERIALS AND METHODS: From June 2005 to December 2016, 56 cases (55 patients, 1 case of bilateral knee) were diagnosed with pyogenic arthritis and arthroscopic treatment was performed. Fourteen patients (25.0%) were identified with causative organisms. The average follow-up period was 12.3 months, and the mean age was 67.8 years old. Twenty-four cases were males and 31 cases were females. Kellgrene–Lawrence grade (K–L grade) I was 6 patients, II was 20 patients, III was 11 patients, and IV was 18 patients. Surgery was performed through six portal. The posterior septum was removed and a drainage tube was inserted from the posterior medial side to the posterior side of the joint. The Lysholm score was used after surgery for a functional evaluation. The K–L grade at the time of admission and at the last follow-up were compared for a radiological evaluation. RESULTS: The mean normalization period of the C-reactive protein was 59.8 days (6–164 days). Intravenous antibiotics were used for an average of 37.1 days. The results of the functional evaluation revealed a mean Lysholm score of 64.5 (30–98) in a total of 56 cases. Two reoperations was performed, but the treatment was completed with same method in all patients. The K–L grade was similar at the time of surgery and at the last follow-up (p>0.05). CONCLUSION: The method of drain insertion in the posteromedial portal after arthroscopic synovectomy and posterior septum resection for pyogenic arthritis is an effective technique that can obtain satisfactory results by inducing proper exudate discharge.
Anti-Bacterial Agents ; Arthritis ; Arthritis, Infectious ; Arthroscopy ; C-Reactive Protein ; Drainage ; Exudates and Transudates ; Female ; Follow-Up Studies ; Humans ; Joints ; Knee ; Male ; Methods

Gout attacks are often accompanied by systemic inflammatory response. The aim of the retrospective study was to compare gout patients in different age groups in terms of their clinical features at gout attacks. Patients, who were treated for gout attack in two tertiary medical centers between January 2000 and April 2014, were divided into young (≤ 50 years), middle-aged, and elderly (> 65 years) groups. Patients in three age groups were compared in terms of presence of fever (> 37.8°C), C-reactive protein (CRP) levels, and erythrocyte sedimentation ratio (ESR) at the gout attacks. Monocytes, which were isolated from 10 consecutive patients who previously experienced gout attacks, were stimulated with monosodium urate (MSU) crystals and cytokine production was measured by flow cytometry. Among 254 patients analyzed in this study, 48 were young, 65 were middle-aged, and 141 were elderly. The elderly patients were more likely to have fever (51.1%) during the attack than the young (20.8%) and middle-aged (30.8%) patients (P < 0.001 by χ² test). They were also more likely to have higher ESR and CRP levels than the young patients (P = 0.002 for ESR, P < 0.001 for CRP). Patients' age correlated significantly with CRP and ESR levels (both P < 0.001). After stimulation with MSU, the production of interleukin-1β by monocytes increased with patients' age (r = 0.670, P = 0.03). In conclusion, gout attacks in elderly patients are associated with fever and higher ESR and CRP levels, often resembling a septic arthritis.
Aged* ; Aging ; Arthritis, Infectious ; Blood Sedimentation ; C-Reactive Protein ; Fever ; Flow Cytometry ; Gout* ; Humans ; Inflammation ; Monocytes ; Retrospective Studies ; Uric Acid