Septic arthritis in rheumatoid disease causing bilateral shoulder dislocation: diagnosis and treatment assisted by grey scale ultrasonography.
Signs of sepsis may be obscure in patients with rheumatoid arthritis, particularly in association with long-term steroid therapy. If mortality is to be avoided, a high index of suspicion must be maintained for the diagnosis, and doubtful joints should be aspirated for culture and prompt therapy with the correct antibiotic. In this report a patients with advanced rheumatoid arthritis presented with bilateral shoulder dislocation due to septic arthritis. Ultrasonography was particularly helpful in guiding a 20 G needle to fluid collections with the debris-filled joint capsules and in facilitating successful aspiration. Ultrasound also provided a painless, noninvasive, and safe method of serial assessment of the joints after therapy.
D001170:Arthritis, Infectious / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D001172:Arthritis, Rheumatoid / Q000150:complications*; D005260:Female; D006801:Humans; D008875:Middle Aged; D012783:Shoulder Dislocation / Q000209:etiology*; D013203:Staphylococcal Infections / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D014463:Ultrasonography