1/74. sacroiliitis - it's not all B 27.We describe an HLA-B27 positive patient in whom posttraumatic pyogenic sacroiliitis led to complete unilateral sacroiliac joint ankylosis in the absence of any signs indicative of HLA-B27 associated spondyloarthropathy. sacroiliitis is the pathologic hallmark - and usually one of the earliest pathologic manifestations - of ankylosing spondylitis (AS). Bilateral sacroiliitis is typical for ankylosing spondylitis. The frequency of asymmetric sacroiliitis may be higher in other inflammatory disorders, e.g., reactive arthritis, Reiters syndrome, spondylitis associated with psoriasis, or inflammatory bowel disease. Most but not all of these disorders show an increased prevalence among individuals who have inherited the HLA-B27 gene. In the context of this case, we discuss the differential diagnosis of unilateral sacroiliitis.- - - - - - - - - - ranking = 1keywords = trauma (Clic here for more details about this article) |
2/74. candida glabrata arthritis: case report and review of the literature of Candida arthritis.We report a case of arthritis due to Candida (Torulopsis) glabrata in two different joints at different times in the same patient. The first episode of arthritis was situated in the right ankle and lasted more than 1 year before the patient agreed to the proposed treatment. Therapy with intravenous amphotericin b and oral fluconazole failed. A cure was achieved with weekly intra-articular administration of amphotericin b, which was continued for more than 20 weeks and combined with oral itraconazole. Several weeks later the patient developed candida glabrata arthritis of the left knee while still taking itraconazole. Immediately, intravenous amphotericin b therapy was started and was successful. Because there were no previous invasive point manipulations or trauma, the infections were considered to be haematogenously disseminated. Chronic corticosteroid and repeated antibiotic therapy for infectious exacerbations of chronic obstructive pulmonary disease and alcohol abuse are the presumed risk factors in this otherwise immunocompetent patient.- - - - - - - - - - ranking = 1keywords = trauma (Clic here for more details about this article) |
3/74. mycobacterium kansasii septic arthritis: French retrospective study of 5 years and review.Septic arthritis due to mycobacterium kansasii is rare; only 40 cases have been published. A French national inquiry revealed the occurrence of 10 new cases between 1992 and 1997 (8 men and 2 women: mean age, 37 years; range, 25-54 years). Seven had an underlying condition: AIDS (n=4), chronic skin psoriasis and AIDS (n=2), or a renal transplant (n=1). Trauma to the joint, use of intra-articular corticosteroid(s) 1 month to 2 years after the event, and chronic skin psoriasis were risk factors. The mean interval between appearance of the first symptoms of arthritis and the diagnosis was 5 months. Monarthritis was localized to the knee (n=4), wrist (n=3), finger (n=1), elbow (n=1), or ankle (n=1). The main diagnostic procedure was culture of a synovial biopsy specimen. In all cases, debridement was associated with antimycobacterial treatment. Three patients died of AIDS during treatment, and another is still undergoing treatment; the other 6 patients were cured. M. kansasii infection should be considered in all cases of indolent arthritis with any of the following risk factors: local trauma, local or systemic corticosteroid therapy, chronic skin psoriasis, and immunodepression, especially that due to human immunodeficiency virus infection.- - - - - - - - - - ranking = 1keywords = trauma (Clic here for more details about this article) |
4/74. Isolation of pantoea agglomerans in two cases of septic monoarthritis after plant thorn and wood sliver injuries.arthritis after plant injury is often apparently aseptic. We report two cases due to pantoea agglomerans. In one case, the bacterium was isolated only from the pediatric blood culture media, BACTEC Peds Plus, monitored in BACTEC 9240, and not from the other media inoculated with the joint fluid. This procedure could help improve the diagnosis of septic arthritis.- - - - - - - - - - ranking = 5.480485005126keywords = injury (Clic here for more details about this article) |
5/74. Epiphyseal separations after neonatal osteomyelitis and septic arthritis.Complete separation of an epiphysis is a rare complication of neonatal osteomyelitis and septic arthritis. We report two cases of pathologic epiphyseal separation after neonatal osteomyelitis, involving the distal and proximal femoral epiphyses with a follow-up of 2 and 7.5 years, respectively. Birth trauma, scurvy, and nonaccidental injury should be considered in the differential diagnosis of pathologic epiphyseal slip. The pitfalls in diagnosis are many, and plain radiograms of unossified epiphyses are often misleading. A high index of suspicion and the use of imaging modalities are useful in making an early diagnosis of epiphyseal slip. The optimal treatment is controversial, and the long-term prognosis is uncertain. The potential for recovery appears to be excellent, provided an early diagnosis is made and prompt treatment by anatomic reduction of the displaced epiphysis is instituted.- - - - - - - - - - ranking = 6.480485005126keywords = injury, trauma (Clic here for more details about this article) |
6/74. Foreign-body synovitis mimicking septic arthritis of the knee.Three cases are presented of recurrent synovitis of the knee in children caused by the presence of foreign material. There was no clear history of trauma. arthroscopy is a useful method providing early diagnosis and simultaneous treatment of this condition.- - - - - - - - - - ranking = 1keywords = trauma (Clic here for more details about this article) |
7/74. A fatal case of vibrio vulnificus presenting as septic arthritis.vibrio vulnificus is an invasive gram-negative bacillus that may cause necrotizing cellulitis, bacteremia, and/or sepsis. Although V vulnificus infection is uncommon, it is frequently fatal and is usually attributed to ingestion of raw shellfish or traumatic exposure to a marine environment; patients are also often found to have a hepatic disorder (cirrhosis, alcohol abuse, or hemochromatosis) or an immunocompromised health status, and most commonly present with septicemia or a wound infection. We describe a patient who presented with septic arthritis as the first clinical manifestation of a V vulnificus infection. The organism was subsequently identified in a synovial fluid aspirate.- - - - - - - - - - ranking = 1keywords = trauma (Clic here for more details about this article) |
8/74. The supratrochlear lymph nodes: their diagnostic significance in a swollen elbow joint.In the differential diagnosis of a swollen elbow, the palpation of the supratrochlear glands is useful. They are not enlarged in a traumatic elbow joint. They are enlarged, discrete and shotty in rheumatoid arthritis. In tuberculosis, they are enlarged, matted and they may caseate and form a cold abscess on the medial aspect of the supratrochlear region of the arm.- - - - - - - - - - ranking = 1keywords = trauma (Clic here for more details about this article) |
9/74. Septic arthritis caused by chryseobacterium meningosepticum in an immunocompetent male.This is the first report of septic arthritis of the knee caused by chryseobacterium meningosepticum. The infection was associated with a penetrating injury to the joint. The patient was cured by flushing of the joint and antibiotic treatment.- - - - - - - - - - ranking = 5.480485005126keywords = injury (Clic here for more details about this article) |
10/74. Community-acquired pseudomonas aeruginosa sacro-iliitis in a previously healthy patient.Pyogenic sacro-iliitis is an uncommon osteo-articular infection that occurs usually in immunocompromised patients and is associated with gram-positive cocci. It is very rarely linked with a gram-negative aetiology. The first case of pseudomonas aeruginosa sacro-iliitis is described, which occurred in a previously healthy young man, without history of prior traumatic events, hospitalisation or chronic underlying disease.- - - - - - - - - - ranking = 1keywords = trauma (Clic here for more details about this article) |
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