Acute septic arthritis in children.
BACKGROUND
Acute septic arthritis is a health-care problem in growing children. The aim of the present study was to determine the demographic features, clinical presentation, diagnostic evaluation, treatment and outcome of children suffering from acute septic arthritis.


METHODS
Retrospective review of consecutive admissions of children < or =14 years of age with a bacteriologically and/or radiologically confirmed diagnosis of septic arthritis during the 10 year period, January 1997-December 2006 at King Fahad Hospital, King Abdulaziz Medical City was undertaken.


RESULTS
Sixty-five patients (male : female, 2.4:1), 10 days-14 years of age (mean +/- SD: 3.3 +/- 3.2 years), met the inclusion criteria. More than half of the patients were under 2 years. The most frequent clinical features were pain (92%), fever (77%), limitation of joint movement (77%) and joint swelling (72%). Joint involvement was monoarticular in 97% of knees, and hips were affected in 75% of patients. Bacteria were isolated from joint aspirate or blood in 28 patients (43%), and Staphylococcus aureus was the most common organism, comprising 39% of the total bacterial isolates. Radiological diagnostic findings were observed in 19 (32%) of 60 patients with plain radiographs, nine (69%) of 16 patients with sonograms of the hip, 36 (80%) of 45 patients with Tc-labeled bone scan and nine (100%) of nine patients with magnetic resonance imaging. The joint infection resolved with no sequelae in 46 patients who were followed up for 6-36 months, but two had bone deformity and 17 were lost to follow up.


CONCLUSIONS
According to the present series, septic arthritis is most common in young infants, mainly monoarticular, and is frequently localized in the knee and hip joints. Early diagnosis and appropriate treatment are associated with excellent outcome.
Al Saadi
Muslim M
MM
Department of Pediatrics, King Khalid University Hospital, College of Medicine, King Saud University, PO Box 2925, Riyadh 11461, Saudi Arabia. malsaadi@yahoo.com
Al Zamil
Fahad A
FA
Bokhary
Nada A
NA
Al Shamsan
Layla A
LA
Al Alola
Sulaiman A
SA
Al Eissa
Youssef S
YS
D000208:Acute Disease; D000293:Adolescent; D001170:Arthritis, Infectious / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000453:epidemiology