1/14. psoas abscess associated with infected total hip arthroplasty.A 65-year-old man with a left uncemented total hip arthroplasty performed 11 years previously was admitted with a history of progressive low back pain, left hip pain, and sepsis that had begun 6 months earlier. On physical examination, a gross, fluctuant mass was palpated in the left thigh. A computed tomography (CT) scan revealed a 6.5 x 3 cm left retrofascial psoas abscess communicating with the hip joint. The patient underwent irrigation and debridement of the hip with removal of the components. The psoas abscess was drained through the iliopsoas bursa. A residual psoas abscess was drained percutaneously under CT guidance. Cultures isolated escherichia coli, and the patient responded to 6 months of ciprofloxacin therapy. After 1 year, the patient had no evidence of infection. Pathways of infection spread, diagnosis, and treatment of a patient with this rare association are discussed with a review of the literature.- - - - - - - - - - ranking = 1keywords = joint (Clic here for more details about this article) |
2/14. Spontaneous expulsion of a screw during urination: an unusual complication 9 years after internal fixation of pubic symphysis diastasis.Nine years after treatment of symphysiolysis and dislocation of the left sacroiliac joint, a screw was spontaneously voided during urination. Unstable plate fixation of the symphysis pubis probably caused screw migration into the bladder, creating a fistula with abscess formation and septic complications.- - - - - - - - - - ranking = 1keywords = joint (Clic here for more details about this article) |
3/14. psoas abscess: the spine as a primary source of infection.STUDY DESIGN: Case report, literature review, discussion. OBJECTIVES: To emphasize the role of the spine as primary source of infection for psoas abscess. SUMMARY OF BACKGROUND DATA: spine-associated psoas abscesses increase with more frequent invasive procedures of the spine and recurring tuberculosis in industrialized countries. Diagnosis is often delayed by misinterpretation as arthritis, joint infection, or urologic or abdominal disorders. methods: We present six cases of psoas abscesses associated with spinal infections that were treated in our hospital from January to December 2001. Diagnostic and treatment concepts are discussed. RESULTS: Our data emphasize the importance of the spine as primary source of infection and suggest an increase in the incidence of secondary psoas abscess. Treatment includes open surgical drainage and antibiotic therapy. In patients with high operative risk and uniloculated abscess, a CT-guided percutaneous abscess drainage can be sufficient. It is essential to combine abscess drainage with causative treatment of the primary infectious focus. Related to the spine, this includes treatment of spondylodiscitis or implant infection after spinal surgery. Usually, several operations are necessary to eradicate bone and soft-tissue infection and restore spinal stability. Continuous antibiotic therapy over a period of 2-3 weeks after normalization of infectious parameters is recommended. CONCLUSION: The spine as primary source of infection for secondary psoas abscess should always be included in differential diagnosis. Because the prognosis of psoas abscess can be improved by early diagnosis and prompt onset of therapy, it needs to be considered in patients with infection and back or hip pain or history of spinal surgery.- - - - - - - - - - ranking = 1keywords = joint (Clic here for more details about this article) |
4/14. Septic facet joint arthritis after a corticosteroid facet injection.Lumbar facet joint injections are commonly employed in the treatment of low back pain and are considered to be relatively safe with few known complications. We report the case of septic facet arthritis following a periarticular facet injection in a patient with recurrent urinary tract infections. The literature is reviewed to identify epidemiological and clinical features of patients in whom septic facet arthritis developed after lumbar facet injection. The diagnosis of iatrogenic septic facet arthritis is often delayed because neurologic and constitutional signs and symptoms develop slowly. Serologic nonspecific markers of infection and appropriate imaging studies may be more sensitive for the early diagnosis of septic facet arthritis. Recalcitrant or worsening back pain after facet injections should prompt an investigation to rule out infectious causes.- - - - - - - - - - ranking = 5keywords = joint (Clic here for more details about this article) |
5/14. escherichia coli septic arthritis of a shoulder in a diabetic patient.escherichia coli septic arthritis is rare and usually occurs in patients with underlying systemic disorders. Most commonly the hip joint is involved and the E. coli septic arthritis is caused by an intraabdominal source (e.g., an abscess communicating with the hip joint). We report the first case of E. coli septic arthritis involving the shoulder joint in a diabetic patient.- - - - - - - - - - ranking = 3keywords = joint (Clic here for more details about this article) |
6/14. Gram-negative arthritis with a simultaneous urinary tract infection in a renal transplant recipient.Infections are common causes of morbidity in the renal transplant population, but infectious arthritis is rarely encountered. Gram-negative joint infections in the nontransplant population are often associated with simultaneous urinary tract infections. We report a case of escherichia coli monoarthritis and a concomitant urinary tract infection in a renal transplant recipient and consider the possible predisposing factors for the infection.- - - - - - - - - - ranking = 1keywords = joint (Clic here for more details about this article) |
7/14. Infection in total joint arthroplasty from distal intravenous lines. A case report.Prevention of late hematogenous infection of a total joint arthroplasty is of great importance because of the catastrophic consequences. Any situation that can lead to a bacteremia should be avoided and appropriate prophylactic antibiotics given in anticipation of a bacteremic episode. This report documents a bacteremia and total joint infection secondary to a routine intravenous line placed in an extremity distal to a total knee arthroplasty. Routine intravenous infusion lines should not be placed in extremities with proximal total joint arthroplasties. Educating both patients and physicians about the risks to a prosthetic joint is important.- - - - - - - - - - ranking = 8keywords = joint (Clic here for more details about this article) |
8/14. Hematogenous infection of total knee implants.Three cases of hematogenous infection of total knee replacement are reported. In two cases septicemia following cholecystectomy resulted in E. coli infection of the knee joint. Prophylactic antibiotic therapy of implant patients undergoing dental or surgical procedures is recommended.- - - - - - - - - - ranking = 1keywords = joint (Clic here for more details about this article) |
9/14. Pneumoarthropathy: an unusual radiographic sign of gram-negative septic arthritis.Gas in the joint and periarticular tissues appeared as an early radiographic manifestation of gram-negative septic arthritis of the hip in a diabetic patient. The features of gram-negative septic arthritis are discussed and the value of an early diagnosis is emphasized.- - - - - - - - - - ranking = 1keywords = joint (Clic here for more details about this article) |
10/14. Septic arthritis associated with avascular necrosis of the femoral head.Avascular necrosis may predispose joints to a septic process particularly in the immunosuppressed individual. The clinical and radiographic presentation may not be diagnostic in the patient with pre-existing joint disease. Suspicion of infection and early aspiration of the involved joint are the keys to early diagnosis. Four patients with avascular necrosis of the femoral head, secondary to renal transplantation and corticosteroids in 3, and systemic lupus erythematosus and corticosteroids in one, presented with super-imposed joint infections. All were treated with intravenous antibiotics and frequent joint aspirations and the infection was resolved.- - - - - - - - - - ranking = 5keywords = joint (Clic here for more details about this article) |
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