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In vivo Macrophage Imaging Using MR Targeted Contrast Agent for Longitudinal Evaluation of Septic Arthritis
Published on: October 20, 2013
Role of Magnetic Resonance Imaging in Concomitant Periarticular Infections in Septic Arthritis of Large Joints in
Varun Garg1, Vivek Singh1, Roop Bhusan Kalia1
1Department of Orthopedics, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India.
Background:
Septic arthritis associated with adjacent infections, presents a diagnostic challenge as the clinical presentation is similar to that of isolated septic arthritis, additional diagnostic tools are needed to detect these infections. The purpose of this study was to examine the effectiveness of magnetic resonance imaging (MRI) for diagnosis of concomitant infection in children with septic arthritis of large joints and its effect on patient outcome and treatment.
Materials And Methods:
Electronic literature research of PubMed, Cochrane and Scopus, was conducted in January 2022 using a combination of MeSH, search terms and keywords. The data extracted included the study details, demographic data, the proportion of patients having a concomitant periarticular infection, clinical presentation, blood parameters and culture findings and outcomes.
Results:
This review included seven studies with 499 patients. The mean age was 7.08 ± 2.38 years in the study. There was a male predominance, with 174 being males (62.36%). The most common joint involved was the hip joint (44.47%). 42.48% had concomitant periarticular infections detected by MRI. Osteomyelitis was the most common infection seen in 209 patients (41.84%). The mean duration of antibiotics given and hospital stay was significantly more in periarticular infections (P > 0.05). 32.5% of the patients with septic arthritis underwent a second surgical procedure whereas 61.11% of patients with periarticular infections underwent second procedure in this review (P > 0.05).
Conclusions:
The use of MRI to diagnose these complicated infections appears to be beneficial. Multi-centric randomised control trials are needed to investigate the efficacy of MRI and its impact on patient care and outcome.
Insights
Magnetic resonance imaging (MRI) aids in diagnosing adjacent infections in pediatric septic arthritis. This imaging technique improves patient outcomes and treatment by identifying concomitant periarticular infections.
Area of Science:
- Pediatric Orthopedics
- Diagnostic Imaging
- Infectious Diseases
Background:
- Septic arthritis with adjacent infections poses diagnostic challenges due to similar clinical presentations.
- Distinguishing between isolated and complicated septic arthritis requires advanced diagnostic tools.
- Magnetic resonance imaging (MRI) is explored for its role in identifying concomitant infections.
Purpose of the Study:
- To evaluate the effectiveness of MRI in diagnosing co-existing infections in pediatric large joint septic arthritis.
- To assess the impact of MRI-detected concomitant infections on patient outcomes and treatment strategies.
Main Methods:
- A comprehensive literature search was conducted across PubMed, Cochrane, and Scopus databases in January 2022.
- Data extraction included study details, demographics, infection rates, clinical presentations, laboratory findings, and patient outcomes.
- Seven studies involving 499 pediatric patients were included in the review.
Main Results:
- 42.48% of patients had concomitant periarticular infections, frequently osteomyelitis (41.84%).
- Patients with periarticular infections experienced longer antibiotic durations and hospital stays.
- A higher percentage of patients with concomitant infections (61.11%) required a second surgical procedure compared to those without (32.5%).
Conclusions:
- MRI appears beneficial for diagnosing complicated septic arthritis involving adjacent infections.
- Further multi-center randomized controlled trials are necessary to confirm MRI's efficacy and impact on patient care.
- Optimizing diagnostic strategies with MRI can potentially improve outcomes for children with septic arthritis.
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