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Septic arthritis of the acromioclavicular joint
Marie Bossert1, Clément Prati, Ewa Bertolini
1Service de rhumatologie, CHU Minjoz, boulevard Fleming, 25030 Besançon, France.
Abstract:
The acromioclavicular joint is rarely the site of septic arthritis. We conducted a retrospective review at our rheumatology department, which identified five cases within the last 6 years. All five patients were males, and their mean age was 63 years. Risk factors were consistently identified and included intravenous substance abuse, prior joint disease, a recent history of intraarticular injections, and a remote history of surgery. Joint aspiration was performed in all five patients and provided the organism in two patients. Blood cultures recovered Staphylococcus aureus in three patients, a coagulase-negative Staphylococcus in one patient, and no organism in one patient. Ultrasonography and/or magnetic resonance imaging established the early diagnosis in four patients and ruled out concomitant involvement of the glenohumeral joint. Only about 20 cases of septic arthritis of the acromioclavicular joint have been reported to date. This rare infection must be diagnosed rapidly to prevent joint destruction. The treatment is that usually recommended for septic arthritis.
Insights
Septic arthritis of the acromioclavicular joint is rare, with only 20 cases reported. Early diagnosis and treatment are crucial to prevent joint destruction.
Area of Science:
- Rheumatology
- Infectious Diseases
- Orthopedic Surgery
Background:
- Septic arthritis of the acromioclavicular joint (ACJ) is an uncommon condition.
- This study reviews five cases identified over six years in a rheumatology department.
Observation:
- The five patients were male, with an average age of 63.
- Identified risk factors included intravenous substance abuse, prior joint disease, intraarticular injections, and remote surgery.
- Common causative organisms were Staphylococcus aureus and coagulase-negative Staphylococcus.
Findings:
- Joint aspiration identified the organism in two patients.
- Blood cultures were positive in four out of five patients.
- Imaging modalities like ultrasonography and MRI aided in early diagnosis and excluded glenohumeral joint involvement.
Implications:
- Prompt diagnosis and treatment are vital to prevent ACJ destruction.
- Treatment protocols for ACJ septic arthritis align with general septic arthritis management.
- Increased awareness and diagnostic vigilance are necessary for this rare condition.
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