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Shoulder pyarthrosis: a concomitant process

W G Ward1, R D Goldner

  • 1Department of Orthopedic Surgery, Cleveland Clinic Foundation, Ohio.

Orthopedics
|July 1, 1994
PubMed
Summary
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Glenohumeral pyarthrosis, a shoulder joint infection, often affects immunocompromised patients with chronic diseases. Delayed diagnosis and treatment significantly worsen outcomes, highlighting the need for prompt evaluation, including the subacromial bursa.

Area of Science:

  • Orthopedics
  • Infectious Diseases
  • Rheumatology

Background:

  • Glenohumeral pyarthrosis is a severe joint infection.
  • Adult patients often present with systemic immune compromise and local tissue abnormalities, frequently linked to chronic debilitating diseases.

Purpose of the Study:

  • To report on thirty cases of glenohumeral pyarthrosis.
  • To identify risk factors, diagnostic challenges, and treatment outcomes.

Main Methods:

  • Retrospective case series analysis of thirty patients with glenohumeral pyarthrosis.
  • Review of patient demographics, comorbidities, clinical presentation, diagnostic findings, treatment, and outcomes.

Main Results:

  • Systemic immune compromise (74%) and local abnormalities (74%) were common; both were present in 52% of adult patients.

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  • Diagnosis was often delayed due to mild, nonspecific symptoms and laboratory findings, correlating with poor outcomes.
  • Successful eradication of postoperative pyarthrosis was limited to patients with intact immune systems.
  • Four patients had pyarthrosis ipsilateral to arteriovenous dialysis fistulas.
  • Ten percent of patients with intact rotator cuffs had associated subacromial bursa abscesses.

    • Conclusions:

    • Delayed diagnosis and treatment are critical factors influencing outcomes in glenohumeral pyarthrosis.
    • Immune status significantly impacts treatment success.
    • Evaluation for glenohumeral pyarthrosis should include assessment of the subacromial bursa due to associated abscesses.