Septic arthritis of the glenohumeral joint: A case series and review of investigative and treatment strategies

Abstract

IntroductionGlenohumeral septic arthritis is most caused by hematogenous seeding of the joint by S. Aureus, and also as a result of previous surgery or intra-articular injection. Although rare, septic arthritis of the glenohumeral joint has poor prognosis. In patients who survive the infection, the potential to cause rapid and catastrophic damage to articular cartilage, frequently causes lifelong morbidity. MethodsFour consecutive patients (five shoulders) treated at our institution between December 2019 to September 2020 were identified for the study. Medical records were reviewed, and basic demographics of the patient series included age, sex, race, BMI were collected. Information such as comorbidities, inciting injuries, history of presentation, examination findings, biochemical results, radiological findings, aspiration results and cultures, intra-operative findings, as well as blood cultures were extracted. ResultsFour patients (age range of 65–83 years old) underwent a single arthroscopic washout of the glenohumeral joint. All four patients (3 female, 1 male) presented with acute swollen should joint/s with raised inflammatory markers (ESR, CRP and WBC). Staph Aureus was identified in 50% (n ​= ​2) of the cases with Mycobacterium Kansasii and Group B Streptococcus isolated in the other 2 patients. Half of the cases (n ​= ​2) were deemed to be caused by direct spread of pathogens whereas the other half of the cases (n ​= ​2) were deemed to be due to hematogenous spread. All patients exhibit resolution of clinical infection following the treatment. MRI were done for all patients which aided in the diagnosis of a septic shoulder joint. ConclusionOur case series shown that single arthroscopic washout and debridement provides acceptable to good short-term outcomes for septic arthritis of the glenohumeral joint. In this case series, the authors have found MRI to be a useful radiographic aid to diagnosis. Level of evidenceCase series.