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Published on: February 25, 2022
Sonographic findings associated with complications in pediatric patients with septic arthritis
Takahiro Hosokawa1, Yumiko Sato1, Yutaka Tanami1
1Department of Radiology, Saitama Children's Medical Center, Saitama, Japan.
Insights
Ultrasound can identify septic arthritis complications in children. Diminished hyperechoic foci within the epiphyseal bone head on ultrasound indicate a higher risk of complications in pediatric septic arthritis.
Area of Science:
- Pediatric Radiology
- Musculoskeletal Ultrasound
- Pediatric Infectious Diseases
Background:
- Septic arthritis is a serious pediatric condition requiring prompt diagnosis and management.
- Ultrasound is a key imaging modality for diagnosing septic arthritis in children.
- Identifying sonographic predictors of complications can improve patient outcomes.
Purpose of the Study:
- To identify sonographic findings associated with complications in pediatric septic arthritis.
- To evaluate the utility of ultrasound in predicting septic arthritis complications.
Main Methods:
- Retrospective analysis of 12 pediatric patients (<5 years) with septic arthritis.
- Classification into groups with and without complications (epiphyseal/metaphyseal bone destruction).
- Comparison of sonographic findings: synovial thickness, effusion, epiphyseal foci, and metaphyseal cortex integrity.
Main Results:
- All patients had joint effusion and synovial thickening.
- Diminished epiphyseal hyperechoic foci were significantly more common in patients with complications (p=0.018).
- Diminished metaphyseal cortex was more frequent in complicated cases, though not statistically significant (p=0.081).
Conclusions:
- Ultrasound is effective for diagnosing pediatric septic arthritis.
- Sonographic findings, particularly diminished epiphyseal hyperechoic foci, can help predict complications.
- Ultrasound aids in risk stratification and management planning for pediatric septic arthritis.
Objectives:
Ultrasound is a valuable tool for diagnosing septic arthritis and guiding the development of treatment plans. This study aimed to identify sonographic findings associated with complications in septic arthritis.
Methods:
Twelve patients aged <5 years diagnosed with septic arthritis were classified into two groups: those with and without complications. Complications were defined as the destruction of the epiphyseal bone head and metaphysis bone cortex. The following sonographic findings were compared between the two groups using Fisher's exact test: synovial membrane thickness, joint effusion, diminished hyperechoic foci within the epiphyseal bone head, and diminished smooth metaphyseal bone cortex.
Results:
Overall, 4 of 12 patients developed complications. Joint effusion and synovial membrane thickening were detected in all patients with septic arthritis. The incidence of diminished hyperechoic foci within the epiphyseal bone head was significantly different between the two groups (presence/absence in patients with complications vs. without = 3/1 vs. 0/8, p = 0.018). The incidence of diminished smooth metaphyseal bone cortex was higher in patients with complications than in those without; however, this difference was not statistically significant (presence/absence in patients with complications vs. without = 4/0 vs. 3/5, p = 0.081).
Conclusion:
Ultrasound proved to be an effective diagnostic tool for septic arthritis and also demonstrated its potential in predicting complications of septic arthritis in the pediatric population.
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