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Periarticular soft tissue calcification and ossification in the septic joint
S Arnold1, J R Sty, R J Starshak
1Department of Radiology, Children's Hospital of Wisconsin, Milwaukee.
Insights
Juxta-articular calcification near the hip in infants may follow anterior surgical drainage. This finding, a potential consequence of elevating the iliac periosteum, does not indicate a poor prognosis.
Area of Science:
- Pediatric Orthopedics
- Surgical Complications
- Bone Metabolism
Background:
- Septic hip drainage in infants is a critical procedure.
- Surgical approaches can influence post-operative outcomes.
- Juxta-articular calcification is a potential, though not fully understood, complication.
Purpose of the Study:
- To investigate the occurrence of juxta-articular calcification following septic hip drainage in infants.
- To determine if the surgical approach influences the development of this calcification.
- To clarify the implications of juxta-articular calcification for patient prognosis.
Main Methods:
- Retrospective review of three infants with juxta-articular calcification adjacent to the ilium.
- Comparison with five infants who underwent septic hip drainage via a posterior approach.
- Analysis of surgical techniques, specifically the elevation of muscle origins during anterior approaches.
Main Results:
- Three infants developed juxta-articular calcification near the anterolateral ilium after anterior hip drainage.
- No calcification was observed in infants treated with a posterior surgical approach.
- The anterior approach involved elevation of sartorius and rectus femoris muscle origins.
Conclusions:
- Juxta-articular calcification following anterior septic hip drainage in infants is likely a sequela of iliac periosteal elevation.
- This calcification is a surgical complication and not indicative of an unfavorable patient outcome.
- Surgical technique modification might be considered to mitigate this specific complication.
Abstract:
We encountered three infants who developed juxta-articular calcification adjacent to the anterolateral aspect of the ilium. All had had drainage of a septic hip using an anterior approach. Calcification was not found among five infants whose septic hips were drained using a posterior approach. Some surgeons who employ the anterior approach facilitate exposure of the joint capsule by elevation of the origins of the sartorius and rectus femoris muscles. We feel this juxta-articular calcification in this setting is a sequla of anterior surgical drainage of the hip in which there has been surgical elevation of the iliac periosteum. It does not imply an unfavorable outcome.