RISK FACTORS AND CLINICAL PRESENTATION OF SEPTIC ARTHRITIS OF HIP IN INFANTS: A PROSPECTIVE STUDY

Authors

  • Padmaraj patil Department of Orthopaedics, PIOS Medilinks Private Limited, Jaysingpur, Maharashtra, India.
  • Satish patil Department of Orthopaedics, PIOS Medilinks Private Limited, Jaysingpur, Maharashtra, India.
  • Pravin Sonune Department of Orthopaedics, PIOS Medilinks Private Limited, Jaysingpur, Maharashtra, India.
  • Gourav Giradkar Department of Orthopaedics, PIOS Medilinks Private Limited, Jaysingpur, Maharashtra, India.

DOI:

https://doi.org/10.22159/ajpcr.2023.v16i5.48133

Keywords:

Septic Arthritis, Morrey's Criteria, Joint Effusion, Clinical Presentation, Outcome

Abstract

Objective: The objective of this study was to analyze the risk factors and clinical presentation of septic arthritis of hip in infants.

Methods: Thirty infants with unilateral septic arthritis of hip were included in this study on the basis of a pre-defined inclusion and exclusion criteria. The study was conducted in PIOS Medilinks Pvt. Limited, Jaysingpur, Kolhapur, India. The duration of the study was 18 months from June 2021 to December 2022. The institutional ethical committee approved the study. The diagnosis of septic arthritis was made on the basis of Morrey’s criteria. Risk factors associated with septic arthritis and clinical presentation were studied.

Results: Out of the total 30 infants diagnosed to be having septic arthritis of unilateral hip, 17 (57.67%) were males and 13 (43.33%) were females. In our study, an overwhelming majority of the patients belonged to neonatal age group (80%) followed by 1 month–2 months (10%). Only 3 infants were between 2 months and 1 year of age (10%). Low birth weight and prematurity or a combination of these two factors was the most common risk factor in neonates with septic hip arthritis and was seen in 7 (23.33%) patients. All infants having septic arthritis had increased local temperature (100%) and reduced joint movements (100%). Erythema (86.67%), swelling (73.33%), and irritability (60%) were other common clinical features associated with septic arthritis. The most common offending organism was Staphylococcus aureus (33.33%) followed by Klebsiella pneumoniae (13.33%). The analysis of outcome at the end of 3-month follow-up showed that out of 30 studied cases, 28 (93.33%) infants had a painless hip with normal range of motion.

Conclusion: Septic arthritis of hip in infants is an emergency and requires prompt treatment. Any delay in diagnosis can have catastrophic consequences. However, in majority of appropriately managed infants, there is no residual damage to the affected joint.

Downloads

Download data is not yet available.

References

Li Y, Zhou Q, Liu Y, Chen W, Li J, Yuan Z, et al. Delayed treatment of septic arthritis in the neonate: A review of 52 cases. Medicine (Baltimore) 2016;95:e5682. doi: 10.1097/MD.0000000000005682, PMID 28002339

Lavy CB. Septic arthritis in Western and sub-Saharan African children-a review. Int Orthop 2007;31:137-44. doi: 10.1007/s00264-006-0169-9, PMID 16741731

De Boeck H. Osteomyelitis and septic arthritis in children. Acta Orthop Belg 2005;71:505-15. PMID 16305073

Shirtliff ME, Mader JT. Acute septic arthritis. Clin Microbiol Rev 2002;15:527-44. doi: 10.1128/CMR.15.4.527-544.2002, PMID 12364368

Kocher MS, Zurakowski D, Kasser JR. Differentiating between septic arthritis and transient synovitis of the hip in children: An evidence-based clinical prediction algorithm. J Bone Joint Surg Am 1999;81:1662-70. doi: 10.2106/00004623-199912000-00002, PMID 10608376

Omene JA, Odita JC. Clinical and radiological features of neonatal septic arthritis. Trop Geogr Med 1979;31:207-12. PMID 505551

Morrey BF, Bianco AJ Jr., Rhodes KH. Septic arthritis in children. Orthop Clin North Am 1975;6:923-34. doi: 10.1016/S0030- 5898(20)30955-X, PMID 1101133

Jeyaraman M, Jeyaraman N, Eswar R, Mohan SR. Arthrotomy and lavage of neonatal septic arthritis: A multicenteric study. J Orthop Bone Dis 2019;3:000186.

Caksen H, Oztürk MK, Uzüm K, Yüksel S, Ustünbaş HB, Per H. Septic arthritis in childhood. Pediatr Int 2000;42:534-40. doi: 10.1046/j.1442- 200x.2000.01267.x, PMID 11059545

Bono KT, Samora JB, Klingele KE. Septic arthritis in infants younger than 3 months: A retrospective review. Orthopedics 2015;38:e787-93. doi: 10.3928/01477447-20150902-56, PMID 26375536

Halder D, Seng QB, Malik AS, Choo KE. Neonatal septic arthritis. Southeast Asian J Trop Med Public Health 1996;27:600-5. PMID 9185277

Devi RU, Bharathi SM, Anitha M. Neonatal septic arthritis: Clinical profile and predictors of outcome. Indian J Child Health 2017;4:10-4.

Kabak S, Halici M, Akcakus M, Cetin N, Narin N. Septic arthritis in patients followed-up in neonatal intensive care unit. Pediatr Int 2002;44:652-7. doi: 10.1046/j.1442-200x.2002.01649.x, PMID 12421264

Wang CL, Wang SM, Yang YJ, Tsai CH, Liu CC. Septic arthritis in children: Relationship of causative pathogens, complications, and outcome. J Microbiol Immunol Infect 2003;36:41-6. PMID 12741732

Young TP, Maas L, Thorp AW, Brown L. Etiology of septic arthritis in children: An update for the new millennium. Am J Emerg Med 2011;29:899-902. doi: 10.1016/j.ajem.2010.04.008, PMID 20674219

Rai A, Chakladar D, Bhowmik S, Mondal T, Nandy A, Maji B, et al. Neonatal septic arthritis: Indian perspective. Eur J Rheumatol 2020;7(Suppl 1):S72-7. doi: 10.5152/eurjrheum.2019.19052, PMID 35929862

Frederiksen B, Christiansen P, Knudsen FU. Acute osteomyelitis and septic arthritis in the neonate, risk factors and outcome. Eur J Pediatr 1993;152:577-80. doi: 10.1007/BF01954084, PMID 8354317

Pääkkönen M. Septic arthritis in children: Diagnosis and treatment. Pediatr Health Med Ther 2017;8:65-8. doi: 10.2147/PHMT.S115429, PMID 29388627

Peltola H, Pääkkönen M, Kallio P, Kallio MJ, Osteomyelitis-Septic Arthritis (OM-SA) Study Group. Prospective, randomized trial of 10 days versus 30 days of antimicrobial treatment, including a short-term course of parenteral therapy, for childhood septic arthritis. Clin Infect Dis 2009;48:1201-10. doi: 10.1086/597582, PMID 19323633

Published

07-05-2023

How to Cite

patil, P., S. patil, P. Sonune, and G. Giradkar. “RISK FACTORS AND CLINICAL PRESENTATION OF SEPTIC ARTHRITIS OF HIP IN INFANTS: A PROSPECTIVE STUDY”. Asian Journal of Pharmaceutical and Clinical Research, vol. 16, no. 5, May 2023, pp. 128-31, doi:10.22159/ajpcr.2023.v16i5.48133.

Issue

Section

Original Article(s)