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Recurrent arthritis as presenting symptom of osteomyelitis

S E Haine1, V J Reenaers, J F Van Offel

  • 1University Hospital of Antwerp, Antwerp (UIA), Belgium.

Clinical Rheumatology
|September 25, 2003
PubMed

Insights

This case report details an adult with recurrent septic arthritis of the knee, initially presenting as prepatellar bursitis. It highlights the rare association of adult patellar osteomyelitis with knee joint infection.

Area of Science:

  • Orthopedics
  • Infectious Diseases
  • Radiology

Background:

  • Recurrent septic arthritis in adults is uncommon.
  • Patellar osteomyelitis is primarily a pediatric condition.
  • Prepatellar bursitis can sometimes mask deeper infections.

Observation:

  • A patient experienced recurrent knee arthritis following prepatellar bursitis.
  • Initial knee aspirations were sterile despite oral antibiotic use.
  • Staphylococcus aureus was eventually cultured from the knee joint.

Findings:

  • X-ray revealed an osteolytic lesion of the patella.
  • MRI demonstrated a communication between patellar osteomyelitis and the knee joint via the medial retinaculum.
  • This represents a rare adult case of associated bursitis, osteomyelitis, and septic arthritis.

Implications:

  • Highlights the importance of thorough investigation in recurrent joint effusions, even after initial sterile cultures.
  • Suggests patellar osteomyelitis can present insidiously in adults.
  • Emphasizes the potential for contiguous spread from bone infection to the joint and bursa.

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