Clin Orthop Surg.  2010 Sep;2(3):186-190. 10.4055/cios.2010.2.3.186.

Arthroscopic Treatment of Septic Arthritis of Acromioclavicular Joint

• Noh KC
• Chung KJ
• Yu HS
• Koh SH
• Yoo JH

• KMID: 999439
• DOI: http://doi.org/10.4055/cios.2010.2.3.186

Abstract

Septic arthritis requires an early diagnosis and proper treatment to prevent the destruction of articular cartilage and joint contracture. This paper presents a rare case of septic arthritis of the acromioclavicular joint that was treated with arthroscopic debridement and resection of the distal clavicle.

Keyword

Acromioclavicular joint; Septic arthritis; Acute; Arthroscopy

MeSH Terms

Acromioclavicular Joint/radiography/*surgery
Arthritis, Infectious/radiography/*surgery
*Arthroscopy
Clavicle/surgery
Humans
Male
Middle Aged

Figure

• 

  Fig. 1 Plain radiography of the right (A) and left (B) acromioclavicular (AC) joint. The left AC joint (B) shows joint space widening relative to unaffected right AC joint (A). The joint margin of the left AC joint shows periarticular bone erosions.

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  Fig. 2 MR images of the left shoulder. (A) T1-weighted image oblique coronal scan shows periarticular bone erosions and joint space widening of the acromioclavicular (AC) joint (arrows). The AC joint shows isosignal intensity relative to the muscle. Periarticular soft tissue shows low signal intensity relative to the adjacent normal fat tissue (curved arrow). The subacromial and subdeltoid space shows low signal intensity relative to the normal fat tissue (open arrows). (B) Fat suppressed proton density weighted image oblique coronal scan shows periarticular bone erosions and joint space widening of the AC joint (arrows). The AC joint shows high intensity relative to the muscle. Periarticular soft tissue shows high signal intensity relative to the adjacent normal fat tissue (curved arrow). The subacromial and subdeltoid space shows high signal intensity relative to the normal fat tissue (open arrows). (C) The T2-weighted image obique sagittal scan show periarticular bone erosions and widening of the AC joint space (arrows). The AC joint shows heterogenous high intensity relative to the muscle. The periarticular soft tissue shows high signal intensity relative to the adjacent normal fat tissue (curved arrow). The subacromial and subdeltoid space shows heterogenous low signal intensity relative to normal fat tissue (open arrows). (D) Fat suppressed Gd-enhancement T1-weighted image oblique coronal scan shows joint space widening (arrows). Periarticular bone marrow and periarticular soft tissue (curved arrow) shows heterogenous contrast enhancement. Subacromial-subdeltoid bursa shows diffuse thickening and contrast enhancement (open arrows). A: Acromion, C: Clavicle, G: Glenoid.

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  Fig. 3 Arthroscopic views show a multiple subchondral punched out bony lesion of the acromioclavicular joint (A) and postoperative findings of arthroscopic debridement and distal clavicle resection (B).

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  Fig. 4 There is no clavicle elevation of the left acromioclavicular joint on the 2 year follow-up X-ray after arthroscopic debridement and distal clavicle resection.

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  Fig. 5 The patient shows a good range of motion on the left shoulder at the 2 year follow-up.

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