scholarly journals Novel Use of the Muscle Sparing Anterolateral Approach for Septic Arthritis of the Native Hip Joint in an Adult: A Case Report

2021 ◽  
Vol 11 (6) ◽  
Author(s):  
Connor Zale ◽  
J Banks Deal Jr. ◽  
Aaron Vaslow ◽  
Gregory Lause ◽  
Bertram Providence
Keyword(s):  
Case Report ◽  
Septic Arthritis ◽  
Hip Joint ◽  
Anterolateral Approach ◽  
Acute Setting ◽  
Hip Arthritis ◽  
Irrigation And Debridement ◽  
A Cell ◽  
Muscle Sparing ◽  
Uncommon Condition

Introduction: Septic arthritis of a native hip is a relatively uncommon condition in adults. Prompt diagnosis and treatment of septic hip arthritis are imperative to preserve joint integrity, as failure to quickly intervene can allow rapid degenerative changes. Case Report: This is a case report of a 50-year-old male that presented with right septic hip arthritis in the acute setting. He complained of pain with attempted range of motion and log-roll. Laboratory workup demonstrated no leukocytosis, but elevated inflammatory markers. A hip aspiration under fluoroscopy was performed, revealing a cell count of 100,600/cm3 with 91% neutrophils. His right hip underwent irrigation and debridement with a muscle-sparing anterolateral approach (Rottinger). Conclusion: This case report describes the successful use of the anterior based muscle-sparing approach for incision and drainage of septic arthritis of the native hip joint in an adult patient. Advantages to this strategy include lower rate of nerve injury compared to classical anterior and lateral approaches, less muscle damage than the posterior approach, and no requirement for special skills or equipment as in the case of hip arthroscopy. Keywords: Septic arthritis, anterior based muscle sparing and anterolateral

scholarly journals Isolated septic arthritis of hip joint: a rare presentation of melioidosis. A case report

2018 ◽  
Vol 11 (1) ◽  
Author(s):  
N. P. Weerasinghe ◽  
H. M. M. Herath ◽  
T. M. U. Liyanage
Keyword(s):  
Case Report ◽  
Septic Arthritis ◽  
Hip Joint ◽  
Rare Presentation

scholarly journals Sternoclavicular Joint Septic Arthritis Manifesting as a Neck Abscess: A Case Report

2003 ◽  
Vol 82 (8) ◽  
pp. 618-621 ◽  
Author(s):  
Atta Mohyuddin
Keyword(s):  
Rheumatoid Arthritis ◽  
Case Report ◽  
Ankylosing Spondylitis ◽  
Septic Arthritis ◽  
Clinical Course ◽  
Correct Diagnosis ◽  
Sternoclavicular Joint ◽  
Neck Abscess ◽  
Uncommon Disease ◽  
Uncommon Condition

Septic arthritis of the sternoclavicular joint is an uncommon condition, and the diagnosis can be missed until a complication occurs. The sternoclavicular joint is more often involved in ankylosing spondylitis, degenerative arthritic conditions (i.e., rheumatoid arthritis and osteoarthritis), and primary and secondary metastatic conditions. The patient described in this case report came to the otolaryngology department on two occasions for treatment of a unilateral cutaneous neck abscess. The correct diagnosis was not made until the second visit. The author reviews the clinical course, diagnosis, and treatment of this uncommon disease.

scholarly journals Traumatic Elbow Arthrotomy Pediatric Case Report: The Saline Load Test is a Reliable Method of Detection

2021 ◽  
Vol 11 (3) ◽  
Author(s):  
Tyler D. Kupchick ◽  
Jacob Carl ◽  
Eric Wall
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Reliable Method ◽  
Pediatric Patients ◽  
Emergency Department Visits ◽  
Load Test ◽  
Definitive Treatment ◽  
Anterolateral Approach ◽  
Irrigation And Debridement

Introduction: Lacerations and open elbow injuries are common emergency department visits which necessitate an orthopedic surgery evaluation for a traumatic elbow arthrotomy (TEA). A delay in this diagnosis can lead to septic arthritis, requiring more invasive surgical procedures, prolonged antibiotics, and possible long-term sequelae. To date, there is scarce literature on TEA. The purpose of this case report is to better educate the orthopedic community on a reliable method of detection for a TEA, including pediatric patients. Case Report: Case 1 – Twelve-year-old boy sustained a traumatic dog bite to the right elbow by a large stray dog. Evaluation in the emergency department revealed five 1 centimeter or smaller lacerations over the lateral elbow and another 1 cm laceration to the volar and proximal forearm. A saline load test (SLT) was performed from a posterior approach and was positive after 20cc of normal saline was injected into the joint. An arthroscopic irrigation and debridement were performed as definitive treatment. He was discharged with Augmentin BID for 7 days. Follow-up appointments at 1 and 4 weeks post-operatively revealed no signs of infection. Case 2 – Seven-year-old boy who was in a bicycle accident and sustained a large laceration over the posterior elbow. Evaluation in the emergency department revealed an approximately 15 by 4 cm laceration over the posterior elbow. A SLT was positive after 30cc’s was injected from the anterolateral approach. He underwent arthroscopic irrigation and debridement as definitive treatment and was discharged home with Cephalexin BID for 7 days. Follow-up appointments at 1 and 4 weeks post-operatively showed no signs of infection. Conclusion: Performing a SLT is a reliable method of detection to evaluate for a TEA. Our case report demonstrated confirmation of TEA in two pediatric patients based on positive SLT. We were able to treat these injuries appropriately with early surgical intervention and prophylactic anti

scholarly journals The giant resectable carcinoma of gall bladder—a case report

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lovenish Bains ◽  
Haraesh Maranna ◽  
Pawan Lal ◽  
Ronal Kori ◽  
Daljit Kaur ◽  
...  
Keyword(s):  
Case Report ◽  
Gall Bladder ◽  
Lymph Node Involvement ◽  
Chronic Cholecystitis ◽  
Large Size ◽  
Node Involvement ◽  
Uncommon Condition ◽  
Well Differentiated ◽  
Vague Abdominal Pain ◽  
Common Malignancy

Abstract Background Gall bladder cancer (GBC) is the fifth most common malignancy in the gastrointestinal system and the most common malignancy of the biliary system. GBC is a very aggressive malignancy having a 5 year survival rate of 19%. Giant Gall Bladder (GGB) is an uncommon condition that can result from cholelithiasis or chronic cholecystitis and rarely with malignancy. Case report A 65 year old lady presented with vague abdominal pain for 12 years and right abdominal lump of size 20 × 8 cms was found on examination. CT scan showed a circumferentially irregularly thickened wall (2.5 cm) of gall bladder indicative of malignancy. Per-operatively a GB of size 24 × 9 cm was noted and patient underwent radical cholecystectomy. It was surprise to find such a giant malignant GB with preserved planes. Histopathology, it was well differentiated adenocarcinoma of gall bladder of Stage II (T2a N0 M0). Discussion It is known that mucocoele of GB can attain large size, however chronic cholecystitis will lead to a shrunken gall bladder rather than an enlarged one. A malignant GB of such size and resectable is rare without any lymph node involvement or liver infiltration. Few cases of giant benign gall bladder have been reported in literature, however this appears to be the largest resectable gall bladder carcinoma reported till date as per indexed literature. Conclusion Giant GB is an uncommon finding. They are mostly benign, however malignant cases can occur. Radiological findings may suggest features of malignancy and define extent of disease. Prognosis depends on stage of disease and resectability, irrespective of size.

scholarly journals Post-operative septic arthritis after arthroscopy: modern diagnostic and therapeutic concepts

2021 ◽  
Author(s):  
Andreas Voss ◽  
Christian G. Pfeifer ◽  
Maximilian Kerschbaum ◽  
Markus Rupp ◽  
Peter Angele ◽  
...  
Keyword(s):  
Septic Arthritis ◽  
Cell Count ◽  
Clinical Symptoms ◽  
Arthroscopic Surgery ◽  
Polymorphonuclear Cells ◽  
Level Of Evidence ◽  
Therapeutic Concepts ◽  
A Cell ◽  
Low Incidence ◽  
Joint Puncture

Abstract Purpose Septic arthritis is a significant complication following arthroscopic surgery, with an estimated overall incidence of less than 1%. Despite the low incidence, an appropriate diagnostic and therapeutic pathway is required to avoid serious long-term consequences, eradicate the infection, and ensure good treatment outcomes. The aim of this current review article is to summarize evidence-based literature regarding diagnostic and therapeutic options of post-operative septic arthritis after arthroscopy. Methods Through a literature review, up-to-date treatment algorithms and therapies have been identified. Additionally, a supportive new algorithm is proposed for diagnosis and treatment of suspected septic arthritis following arthroscopic intervention. Results A major challenge in diagnostics is the differentiation of the post-operative status between a non-infected hyperinflammatory joint versus septic arthritis, due to clinical symptoms, (e.g., rubor, calor, or tumor) can appear identical. Therefore, joint puncture for microbiological evaluation, especially for fast leukocyte cell-count diagnostics, is advocated. A cell count of more than 20.000 leukocyte/µl with more than 70% of polymorphonuclear cells is the generally accepted threshold for septic arthritis. Conclusion The therapy is based on arthroscopic or open surgical debridement for synovectomy and irrigation of the joint, in combination with an adequate antibiotic therapy for 6–12 weeks. Removal of indwelling hardware, such as interference screws for ACL repair or anchors for rotator cuff repair, is recommended in chronic cases. Level of evidence IV.

scholarly journals Bilateral Congenital Humeroradial Synostostis Presenting with Bilateral Proximal Radius Fractures: A Case Report

2021 ◽  
pp. 29-32
Author(s):  
Elsiddig E. Mahmoud
Keyword(s):  
Case Report ◽  
Elbow Joint ◽  
Parental Education ◽  
Functional Disability ◽  
Congenital Abnormalities ◽  
Rare Condition ◽  
Radius Fractures ◽  
Proximal Radius ◽  
History Of ◽  
Uncommon Condition

Congenital bilateral humeroradial synostosis (HRS) is a rare condition. It is generally divided into 2 categories. In the first group, which is mainly sporadic, additional upper limb hypoplasia typically coexists. In the second group, which is classically familial, HRS is commonly an isolated upper extremity anomaly. HRS can lead to variable degrees of functional disability. The clinical case reported here illustrates a possibly avoidable presentation of this uncommon condition. In this case report, we present a 6-week-old male who presented with bilateral radius fractures. Radiography revealed congenital HRS at both elbows. No other associated congenital abnormalities were detected, and there was no family history of similar conditions in any first-degree relatives. In cases of congenital HRS, movement at the elbow joint is not possible. Parents who are unaware of this information might try to straighten their infant’s elbows, which in turn may result in fractures of the proximal radius. Hence, early diagnosis and proper parental education could prevent fractures as a sequela of HRS.

scholarly journals Phenylketonuria and juvenile idiopathic arthritis: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ting Ting Zhu ◽  
Jin Wu ◽  
Li Yuan Wang ◽  
Xiao Mei Sun
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Case Report ◽  
Autoimmune Diseases ◽  
Hip Joint ◽  
Metabolic Disorder ◽  
Rare Case ◽  
Molecular Data ◽  
Methotrexate Therapy ◽  
Case Presentation

Abstract Background Phenylketonuria (PKU) is a genetic metabolic disorder in which patients have no ability to convert phenylalanine to tyrosine. Several autoimmune diseases have been reported to combine with PKU, co-existent of PKU and Juvenile Idiopathic Arthritis (JIA) has not been presented. Case presentation The girl was diagnosed with PKU at the age of 1 month confirmed by molecular data. At the age of 3.5 years, she presented with pain and swelling of her right ankle, right knee, and right hip joint. After a serial of examinations, she was diagnosed with JIA and treated with a nonsteroidal anti-inflammatory drug. Conclusions We report a rare case of a 4-year-old girl with PKU and JIA, which supports a possible interaction between PKU and JIA. Long-term metabolic disturbance may increase the susceptibility to JIA. Further chronic inflammation could alter the metabolism of tryptophan and tyrosine to increase blood Phe concentration. In addition, corticosteroid and methotrexate therapy for JIA may increase blood Phe concentration.

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