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Osteoarthritis, septic arthritis

Michael P Palmer, Rachael Melton-Kreft, Laura Nistico, N Louisa Hiller, Leon H J Kim, Gregory T Altman, Daniel T Altman, Nicholas G Sotereanos, Fen Z Hu, Patrick J De Meo, Garth D Ehrlich
BACKGROUND: Preliminary studies have identified known bacterial pathogens in the knees of patients with osteoarthritis (OA) before arthroplasty. AIMS: The current study was designed to determine the incidence and types of bacteria present in the synovial fluid of native knee joints from adult patients with diagnoses of septic arthritis and OA. PATIENTS AND METHODS: Patients were enrolled between October 2010 and January 2013. Synovial fluid samples from the affected knee were collected and evaluated with both traditional microbial culture and polymerase chain reaction-electrospray ionization-time-of-flight mass spectrometry (molecular diagnostics [MDx]) to prospectively characterize the microbial content...
October 17, 2016: Genetic Testing and Molecular Biomarkers
Sung-Won Yang, Jin-Yong Cho, Hyeon-Min Kim
Septic arthritis of the temporomandibular joint (TMJ) is a rare disease. The most common symptoms of this disease are acute malocclusion, limited mouth opening, swelling, and tenderness of affected TMJ. These symptoms are often confused with internal derangement of the articular disc, rheumatoid arthritis, retrodiscitis, or osteoarthritis. Therefore, differential diagnosis by image examination is required. Usually, antimicrobial treatment and surgical drainage by needle aspiration, arthroscopy, or arthrotomy are effective treatment approaches...
August 2016: Journal of the Korean Association of Oral and Maxillofacial Surgeons
Cristina Calvo, Esmeralda Núñez, Marisol Camacho, Daniel Clemente, Elisa Fernández-Cooke, Rosa Alcobendas, Luis Mayol, Pere Soler, Miren Oscoz, Jesús Saavedra-Lozano
BACKGROUND: Acute osteoarticular infection (OAI) is a potentially severe disease. The aim of this study was to evaluate the etiology, clinical characteristics and therapeutic approach of OAI in children in Spain. METHODS: Medical records from children <14 years with OAI from 25 hospitals between 2008-2012, were reviewed. Confirmed osteomyelitis (OM) and septic arthritis (SA) required a positive bacterial isolate; otherwise, they were considered probable. Probable SA with <40,000 cells/mm3 in joint fluid were not included...
July 22, 2016: Pediatric Infectious Disease Journal
Sarah Nitoslawski, Todd M McConnell, Makeda Semret, Michael A Stein
A 76-year-old man with a history of osteoarthritis presents with right leg erythema and inability to weight-bear and pain in his right shoulder. Synovial fluid cell count of the knee and shoulder showed abundant neutrophils, and cultures of the knee showed growth of Pasteurella multocida. The patient owned four cats with which he had frequent contact, but history and physical examination elicited no evidence of scratches or bites. This case highlights the invasive potential of Pasteurella multocida in an immunocompetent individual and its capacity to cause septic arthritis in the setting of frequent animal contact...
2016: Canadian Journal of Infectious Diseases & Medical Microbiology
Victoria H Wilkinson, Emma L Rowbotham, Andrew J Grainger
The foot and ankle are commonly involved in a range of arthritides that affect the joints, bones, and soft tissues. Accurate plain film interpretation can often aid the diagnosis and monitor disease progression and treatment response. Ultrasound and MRI afford superior depiction of the soft tissues, and advances over recent years have centered on early detection of synovitis, enabling earlier diagnosis and treatment. Advantages and disadvantages of the imaging techniques of radiography, multidetector computed tomography, ultrasound, and MRI are discussed, as is optimization of these modalities for the assessment of the anatomically complex joints of the foot and ankle...
April 2016: Seminars in Musculoskeletal Radiology
Marine Ferreyra, Guillaume Coiffier, Jean-David Albert, Claire David, Aleth Perdriger, Pascal Guggenbuhl
OBJECTIVE: To evaluate the performance of combined cytology and microcrystal detection in joint fluid for diagnosing septic arthritis. METHODS: Retrospective single-center study of joint fluid samples from patients with manifestations suggesting acute or chronic arthritis. The absolute leukocyte count (/mm(3)) was recorded; as well as the differential counts, particularly of neutrophils (%). Microcrystals were sought and bacteriological cultures performed. Septic arthritis was defined as positive cultures of joint fluid or blood samples...
June 2, 2016: Joint, Bone, Spine: Revue du Rhumatisme
Motoki Sonohata, Masaru Kitajima, Shunsuke Kawano, Riki Tanaka, Masaaki Mawatari
BACKGROUND: Schanz osteotomy is one of the options for the management of hip instability caused by congenital or septic arthritis. Following Schanz osteotomy, there is risk of hip pain secondary to hip arthritis. It may be necessary to perform subtrochanteric femoral osteotomy in conjunction with total hip arthroplasty (THA). This study evaluates the outcomes and complications associated with THA. METHODS: We performed 36 THA after Schanz osteotomy. Patients were divided into three groups: (1) successful Schanz osteotomy, (2) highly dislocated hip with contact between the femoral head and pelvis, and (3) completely dislocated hip without contact between the femur and pelvis...
July 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Masaaki Sakamoto, Hitoshi Watanabe, Hitoshi Kubosawa, Takeshi Ishii
A 63-year-old male consulted our institution due to worsening of right hip pain for approximately one month. The patient had no apparent functional disorders besides rigidity of the right ankle secondary to childhood poliomyelitis. Plain radiographs demonstrated narrowing of the right hip joint space. Magnetic resonance imaging (MRI) showed unusual findings in the right gluteus medius muscle, suspecting a malignant musculoskeletal tumor. Further examinations clarified acute inflammation caused by Staphylococcus aureus with no atypia...
2016: Case Reports in Orthopedics
Santiago Salazar Botero, Juan Jose Hidalgo Diaz, Anissa Benaïda, Sylvie Collon, Sybille Facca, Philippe André Liverneaux
In adults, mallet finger is a traumatic zone I lesion of the extensor tendon with either tendon rupture or bony avulsion at the base of the distal phalanx. High-energy mechanisms of injury generally occur in young men, whereas lower energy mechanisms are observed in elderly women. The mechanism of injury is an axial load applied to a straight digit tip, which is then followed by passive extreme distal interphalangeal joint (DIPJ) hyperextension or hyperflexion. Mallet finger is diagnosed clinically, but an X-ray should always be performed...
March 2016: Archives of Plastic Surgery
Porter Young, Kelly C Homlar
As intra-articular corticosteroid injections (CSIs) are a common treatment for osteoarthritis, physicians must well understand their potential side effects. Postinjection flares are an acute side effect of intra-articular CSIs, with symptoms ranging from mild joint effusion to disabling pain. The present case involved a severe postinjection flare that occurred after the patient, a 56-year-old woman with moderate osteoarthritis in the left knee, received 2 mL of 1% lidocaine and 2 mL (40 mg) of triamcinolone acetonide (Kenalog)...
March 2016: American Journal of Orthopedics
Masters M Richards, Joshua Shane Maxwell, Lihui Weng, Mathew G Angelos, Jafar Golzarian
OBJECTIVES: Knee osteoarthritis (OA) is a debilitating condition that may ultimately require total knee arthroplasty (TKA). Non-operative treatments are bracing, oral analgesics, physical therapy, and intra-articular knee injection (IAKI). The objective of this paper is to provide a systematic literature review regarding intra-articular treatment of knee OA and insight into promising new products of regenerative medicine that may eventually have a substantial effect on treatment. METHODS: A literature search was executed using Medline, Cochrane, and Embase with keywords "knee osteoarthritis" and "injection...
2016: Physician and Sportsmedicine
P Siengdee, T Euppayo, K Buddhachat, S Chomdej, K Nganvongpanit
Fluoroquinolones (FQs) are frequently used for septic arthritis. Increased antibacterial activity has been associated with mammalian cell cytotoxicity that may increase the risk of developing osteoarthritis. This study compared the direct effects of two different FQs, enrofloxacin (Enro) and marbofloxacin (Mar), on normal primary canine chondrocytes and inflammatory-stimulated chondrocytes, in addition to their administration in combination with hyaluronan (HA). Cell viability, cell apoptosis, s-GAG production, and expression patterns of inflammatory, extracellular matrix (ECM) component and protease genes were measured...
October 2016: Journal of Veterinary Pharmacology and Therapeutics
Emmanuel Maheu, François Rannou, Jean-Yves Reginster
The European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) treatment algorithm recommends intra-articular (IA) hyaluronic acid (HA) for management of knee osteoarthritis (OA) as second-line treatment in patients who remain symptomatic despite use of non-steroidal anti-inflammatory drugs (NSAIDs). This recommendation is based upon accumulating evidence that IA HA provides a significant benefit in knee OA. There is good evidence that IA HA injections reduce pain and increase function in knee OA, and the benefits are long-lasting as compared with IA corticosteroids...
February 2016: Seminars in Arthritis and Rheumatism
Xi Chen, Houshan Lyu, Tiezheng Sun
OBJECTIVE: To summarize the mid-term follow-up results of revision of total knee arthroplasty and compare the different strategies for infective revisions. METHODS: All of 45 patients (47 operated knees) lived in Beijing were treated from April 1989 to October 2010 in Arthritis Clinic and Research Center, Peking University People's Hospital. There were 6 male and 39 female patients, who aged from 31 to 77 years (mean (62 ± 11) years). The function of knee, satisfaction and imaging then were compared retrospectively...
October 1, 2015: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Antonio García-Jiménez, Núria Prim, Xavier Crusi, Natividad Benito
OBJECTIVES: Clostridium species are anaerobic bacilli that are rarely reported as etiologic agents of infectious arthritis. Previous cases of arthritis caused by Clostridium ramosum have not been reported. We describe the first 2 cases of C. ramosum arthritis. METHODS: We reviewed the etiology of arthritis in our hospital during the previous 15 years. RESULTS: Both patients had underlying immunocompromising conditions and their infections involved a joint with preexisting disease: patient 1 had rheumatic arthritis and a prosthetic joint; patient 2, chronic renal failure on dialysis and hip osteoarthritis...
April 2016: Seminars in Arthritis and Rheumatism
Philipp Schuster, Martin Schulz, Micha Immendoerfer, Philipp Mayer, Michael Schlumberger, Joerg Richter
BACKGROUND: Septic arthritis after anterior cruciate ligament (ACL) reconstruction is a rare but severe complication. Treatment regimens differ, and optimal management has not been established. PURPOSE: To determine the incidence of postoperative infections after ACL reconstruction, to identify the microbiological spectrum, and to evaluate a standardized graft-retaining treatment protocol consisting of sequential arthroscopic irrigation and debridement (I&D) procedures and antibiotic therapy until C-reactive protein levels are within normal range...
December 2015: American Journal of Sports Medicine
Young-Kyun Lee, Ki-Choul Kim, Yong-Chan Ha, Kyung-Hoi Koo
BACKGROUND: Septic arthritis of the knee has been reported recently in adult patients who were administered hyaluronate. We evaluated the incidence of septic knees and the utilization of hyaluronate in the Korean adult population using nationwide data from the Health Insurance Review and Assessment Service (HIRA). METHODS: All new admissions to the clinics or hospitals for septic knees were recorded in the HIRA database which was established by the Korean government and covers the Korean population using the International Classification of Diseases-10 revision code...
September 2015: Clinics in Orthopedic Surgery
Fernanda Pintor, Rolando Carrasco, Francisco Verdugo-Avello, Mirtha Landaeta
Septic arthritis of the temporomandibular joint (TMJ) is an uncommon condition, caused by hematic bacterial migration or direct migration of other head and neck infections. We report a 41 year old female who presented a right temporomandibular joint involvement, with bone destruction of the mandibular condyle and an infectious process spreading to the temporal space, following a necrotizing medial and external otitis with associated mastoiditis. A septic arthritis of the TMJ by continuity was diagnosed and treated with antimicrobials, TMJ arthrocentesis and occlusal stabilization, with a positive evolution...
June 2015: Revista Médica de Chile
Sapna Lohiya, Jasjit Dillon
This report describes 2 patients whose septic arthritis of the temporomandibular joint (SATMJ) presented atypically, resulting in treatment delay and complications. A 49-year-old man developed left-side facial allodynia, which was first treated unsuccessfully as trigeminal neuralgia. On day 21, the patient sustained facial trauma from a fall and presented to the emergency department (ED). Maxillofacial contrast-enhanced computed tomographic (CT) scan was suggestive of parotiditis, SATMJ, or hemarthrosis. His condition did not improve with empiric antibiotic treatment...
January 2016: Journal of Oral and Maxillofacial Surgery
Torsten Diekhoff, Katharina Ziegeler, Eugen Feist, Tobias Kiefer, Jürgen Mews, Bernd Hamm, Kay-Geert A Hermann
OBJECTIVES: Dual-energy computed tomography (DECT) is an emerging imaging technique for examining patients with suspected gout. Single-source dual-energy CT (S-DECT) is a new way of obtaining DECT information on conventional CT scanners rather than using special dual-source CT systems. METHODS: We tested the feasibility of S-DECT (320-row CT; Aquilion ONE, Toshiba Medical Systems, Otawara, Japan) in 6 patients (5 men, 1 woman; mean age 61.3, range 48 to 69 years) with acute arthralgia and suspected gout, and compared the S-DECT findings with the results of joint aspiration...
November 2015: Skeletal Radiology
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