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Pyarthrosis simulating ruptured rotator cuff syndrome

E J Gordon, G A Hutchful

    Southern Medical Journal
    |June 1, 1982
    PubMed
    Summary
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    A shoulder infection (pyarthrosis) developed after an intra-articular steroid injection for suspected rotator cuff injury. Prompt surgical treatment and antibiotics led to a good recovery, highlighting potential risks of injections.

    Area of Science:

    • Orthopedic Surgery
    • Infectious Disease
    • Musculoskeletal Medicine

    Background:

    • Rotator cuff injuries are common shoulder ailments.
    • Intra-articular steroid injections are frequently used for pain management in shoulder conditions.
    • Complications, though rare, can occur following joint injections.

    Observation:

    • A 50-year-old male presented with severe right shoulder pain two weeks post-injury.
    • Initial diagnosis was ruptured rotator cuff syndrome, treated with an intra-articular steroid injection.
    • Clinical deterioration prompted surgical exploration.

    Findings:

    • Purulent fluid and necrotic debris were discovered within the shoulder joint during surgery.
    • The rotator cuff tendons were found to be anatomically intact, ruling out a primary tear.

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  • Microbiological analysis confirmed a pyarthrosis (joint infection).

    • Implications:

    • Intra-articular steroid injections, while beneficial, carry a risk of inducing joint infections.
    • Early recognition and aggressive surgical management (debridement, irrigation) are crucial for treating pyarthrosis.
    • This case underscores the importance of considering infectious complications after joint injections, even with initial diagnoses like rotator cuff tears.