J Korean Soc Surg Hand.  2012 Dec;17(4):166-172. 10.12790/jkssh.2012.17.4.166.

Open Synovectomy for Chronic Infectious Arthritis of the Wrist

• Lee S
• Sohn S
• Jeon SH
• Shin YW

• KMID: 1425259
• DOI: http://doi.org/10.12790/jkssh.2012.17.4.166

Abstract

PURPOSE
We reported the results of open synovectomy for chronic infectious arthritis of the wrist.
METHODS
Fifteen patients who had chronic infectious arthritis of the wrist and underwent open synovectomy were reviewed retrospectively baesd on preoperative periods, symptoms, results of laboratory tests, radiological findings including magnetic resonance imaging (MRI), hospitalization period, and others. Pain scale and subjective satisfaction were checked by phone interview.
RESULTS
Average preoperative period was 96.1 days. Pain on motion and edema were observed in all cases. Four patients had positive bacterial cultures and three were identified as tuberculous infection. Signal changes of bones were observed in MRI of 10 patients. Osteomyelitis was found in 8 patients during the operation and bone resection or fusion should be performed in three. Average number of operation times was 1.53.
CONCLUSION
When the patients show chronic swelling and pain on motion of the wrist, diagnostic work-ups for chronic infectious arthritis should be performed including arthrocentesis and MRI. Treatment including open synovectomy should be done immediately.

Keyword

Wrist; Chronic infectious arthritis; Arthrocentesis; Magnetic resonance imaging; Mycobacterium

MeSH Terms

Arthritis, Infectious
Edema
Hospitalization
Humans
Magnetic Resonance Imaging
Mycobacterium
Osteomyelitis
Preoperative Period
Retrospective Studies
Wrist

Figure

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  Fig. 1 Wrist magnetic resonance imaging of 68-year-old female patient, who visited 4 months after onset of the symptoms, shows diffuse synovial hypertrophy, joint effusion, and multiple bony erosions and marrow edema.

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