J Korean Orthop Assoc.  2010 Aug;45(4):321-325.

Arthroscopic Treatment for Septic Arthritis of the Shoulder in Neonates

• Yoon HK
• Kim MH
• Lee BI

Abstract

Septic arthritis of the shoulder joint in a neonate is very rare. Damage to the growth plate and ossification center of the proximal humerus may lead to disability of the shoulder joint. Therefore, early diagnosis and proper treatment are very important. We treated septic arthritis of the shoulder joint in a 9-day old newborn baby by arthroscopic irrigation and debridement using a 2.4 mm wrist arthroscope instrument. We could achieve a satisfactory result by inspecting the inside condition of the joint directly, removing granulation tissues and debris and washing out the joint by arthroscopy.

Keyword

neonate; shoulder; septic arthritis; arthroscopy

MeSH Terms

Arthritis, Infectious
Arthroscopes
Arthroscopy
Debridement
Early Diagnosis
Granulation Tissue
Growth Plate
Humans
Humerus
Infant, Newborn
Joints
Shoulder
Shoulder Joint
Wrist

Figure

• 

  Figure 1 T2 fat suppression coronal (A) and enhanced T1 fat suppression axial (B) MR images show pus pocket (arrow) with synovial hypertrophy and high signal change around muscle.

• 

  Figure 2 Initial arthroscopic finding shows in flammatory granulation tissues at superior (A) and inferior (B) aspect of joint space.

• 

  Figure 3 Postoperative arthroscopic finding after debridement and irrigation of joint (B) shows clear joint space.

Reference

1. Gafur OA, Copley LA, Hollmig ST, Browne RH, Thornton LA, Crawford SE. The impact of the current epidemiology of pediatric musculoskeletal infection on evaluation and treatment guidelines. J Pediatr Orthop. 2008. 28:777–785.

2. Lejman T, Strong M, Michno P, Hayman M. Septic arthritis of the shoulder during the first 18 months of life. J Pediatr Orthop. 1995. 15:172–175.

3. Forward DP, Hunter JB. Arthroscopic washout of the shoulder for septic arthritis in infants. A new technique. J Bone Joint Surg Br. 2002. 84:1173–1175.

4. Knudsen CJ, Hoffman EB. Neonatal osteomyelitis. J Bone Joint Surg Br. 1990. 72:846–851.

5. Jackson MA, Nelson JD. Etiology and medical management of acute suppurative bone and joint infections in pediatric patients. J Pediatr Orthop. 1982. 2:313–323.

6. Samilson RL, Bersani FA, Watkins MB. Acute suppurative arthiritis in infants and children; the importance of early diagnosis and surgical drainage. Pediatrics. 1958. 21:798–804.

7. Kwon JW, Sohn KT, Shin SH, Park JH. Diagnosis of bone and joint infection in neonates. J Korean Orthop Assoc. 1999. 34:979–984.

8. Baitch A. Recent observation of acute suppurative arthiritis. Clin Orthop. 1962. 22:157–166.

9. Al Saadi MM, Al Zamil FA, Bokhary NA, Al Shamsan LA, Al Alola SA, Al Eissa YS. Acute septic arthritis in children. Pediatr Int. 2009. 51:377–380.

10. Oh IS, Moon DH, Kim JM. Acute suppurative arthritis in neonatal period. J Korean Orthop Assoc. 1994. 29:1347–1356.