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Archives de pédiatrie
Volume 26, n° 1
pages 38-43 (janvier 2019)
Doi : 10.1016/j.arcped.2018.11.001
Received : 13 August 2018 ;  accepted : 10 November 2018
Research papers

Septic elbow arthritis in children: Epidemiology and outcome
 

H. Kaziz , M.A. Triki, T. Mouelhi, K. Bouattour, N. Naouar, M.L. Ben Ayeche
 Orthopedics department, Sahloul University, Hospital Sousse Tunisia, 4045 Sousse, Tunisia 

Corresponding author.
Abstract
Introduction

Septic elbow arthritis is a rare disease, especially in children. The aim of this study was to report the functional outcome of our pediatric population with both demographic and microbiological features.

Methods

We retrospectively reviewed all our cases of pediatric septic elbow arthritis between 2007 and 2017. Demographic, microbiological, biological, and radiological features were analyzed. Functional outcome was evaluated according to the Morrey Elbow Performance Score (MEPS).

Results

In total, 14 cases were reviewed. The mean age was 9 years. Microbiological findings revealed Staphylococcus aureus in 10 cases. The mean white blood cells count in synovial fluid was 101,306 cells per mm 3. The skin was the most frequently reported entry portal. The mean MEPS score was 86.13 points (excellent in eight cases, good in three cases, fair in two cases, and poor in two cases). Stiffness was observed in three cases. No growth disturbance was reported.

Discussion

Septic elbow arthritis in children is rare. Biological inflammatory markers are sensitive but not specific. White blood cell count in the synovial fluid is specific. S. aureus is the most frequently cultured agent. Treatment is based on surgical debridement, antibiotics, and elbow immobilization. Concomitant osteomyelitis is frequent and should be diagnosed and treated simultaneously. Functional outcomes are usually satisfactory in contrast to osteomyelitis.

Conclusion

Pediatric septic elbow arthritis is rare. It may be primary or secondary to trauma and surgery of the elbow. Demographic, biological, and microbial features are similar to those reported for osteomyelitis; however, functional outcomes are better with a negligible rate of growth disturbance.

The full text of this article is available in PDF format.

Keywords : Septic, Elbow, Arthritis, Children, Data, Outcome




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