Septic arthritis of the pubis symphysis: clinical and therapeutic features.

Zeineb Alaya,Walid Osman,Houneida Zaghouani,Nader Naouar,Lassad Hassini,Mohamed Laziz Ben Ayèche,Elyès Bouajina

doi:10.11604/pamj.2017.26.215.12204

Zeineb Alaya, Walid Osman + Show 5 more

Open Access

https://doi.org/10.11604/pamj.2017.26.215.12204

Copy DOI

Abstract

Septic arthritis of the pubis symphysis is rare and difficult to diagnose. The objective of our study was to describe the biological, clinical, radiological and therapeutic aspects of this disease. This is a retrospective study of 4 cases of septic arthritis of the pubic symphysis collected in the Department of Rheumatology and Orthopaedics in Sousse in Tunisia over a period of 16 years (2000-2016). Our population consists of 3 women and one men. The mean age was 47 years (18-83). Clinical signs of appeal were inflammatory groin pain, pubic pain and fever. Symptoms appeared after forceps delivery in 2 cases, after surgery on the pelvis in one case and in a context of sepsis in one case. Radiographs showed pubic disjunction with irregular shoreline in all cases. CT performed in all patients and MRI in 2 patients showed erosions of the banks of the pubic symphysis with infiltration of the soft parts in all cases. The causative organisms were isolated in 3 cases by biopsy of soft tissue abscess under CT in 2 cases and vaginal swab in one case. Identified germs were staphylococcus aureus Méti-S (n=1), proteus mirabilis (n=1) and varied flora (n=1). The treatment consisted of appropriate antibiotics in all cases and surgical drainage of soft tissue abscess resistant to medical treatment in 2 cases. The outcome was favorable in all cases. Diagnosis of septic arthritis of the pubic symphysis is based on clinic supported by microbiologic culture results, image methods, and proteins augment during acute phase.

Highlights

Septic arthritis or osteomyelitis of the pubis symphysis is a rare condition that occurs in less than 1% of cases of osteomyelitis [13]
It is often misdiagnosed due to the fact that the usual presenting symptoms are very nonspecific, delaying definitive treatment [1-3]. It should be suspected in patients with inflammatory groin pain, pubic pain and fever [1,2,4]
The objective of our study was to describe the biological, clinical, radiological and therapeutic aspects of septic arthritis of the pubic symphysis. This is a retrospective, descriptive study of 4 cases of septic arthritis of the pubic symphysis collected in the Department of Rheumatology and Orthopaedics in Sousse in Tunisia over a period of 16 years (2000-2016)

Summary

Introduction

Septic arthritis or osteomyelitis of the pubis symphysis is a rare condition that occurs in less than 1% of cases of osteomyelitis [13]. It is often misdiagnosed due to the fact that the usual presenting symptoms are very nonspecific, delaying definitive treatment [1-3]. It should be suspected in patients with inflammatory groin pain, pubic pain and fever [1,2,4]. It is frequently associated with prior gynaecological/urological surgery or pelvic malignancy [1,5]. The objective of our study was to describe the biological, clinical, radiological and therapeutic aspects of septic arthritis of the pubic symphysis

Objectives

Results

Discussion

Conclusion