Paediatric Septic Arthritis in a Nigerian Tertiary Hospital: A 5-Year Clinical Review

Septic arthritis is a relatively common condition in the paediatric population. It is both a medical and a surgical emergency with potential high morbidity. This disabling disease requires early diagnosis and prompt management for optimal outcome.

This study determined the epidemiological pattern of septic arthritis and analysed factors affecting morbidity and mortality in the paediatric population.

Retrospective data was obtained over a 5-year period in NKST rehabilitation hospital, Mkar, Nigeria. Forty patients aged 0-17 years met the criteria for inclusion. Joint aspirates were taken for microbiologic investigation. Data was analysed using SPSS version 21.

A total of 40 patients with 48 septic joints were studied. Twenty-two (55.0%) were males and eighteen (45.0%) were female with a male to female ratio of 1.2:1. The hip was the commonest 24(50.0%) joint involved; followed by the knee joint 18(37.5%), shoulder joint 4 (8.4%) and ankle joint 2(4.2%). Result of aspirate cultures yielded Staphylococcus aureus in 34 (70.8%) cases, Escherichia coli in 8 (16.7%), Haemophillus influenzae in 2(4.2%) and no growth was obtained in 4(8.3%) cases. Complications encountered after follow up include stiffness in 8(16.6%) joints, pain and stiffness in 2(4.1%) joint and bony ankylosis in 4(8.4%) joints and limb shortening in 2(4.1%) joints.

The keys to proper management are a high index of suspicion in any child with painful joint dysfunction and strict adherence to the principles of treatment. With prompt treatment, all complications might be avoided, and normal joint function and future growth may be preserved.