To study epidemiological pattern and clinical and radiological parameters of recovery of septic arthritis in nfants and neonates admitted in B.R.D medical college, Gorakhpur

Abstract

Introduction: Prior to the antibiotic era and more enlighten surgical approaches, the occurrence of septic arthritis presented literal threat to life and limb. Despite potent antibiotics, Septic arthritis continues to be one of the most damaging and prevalent form of arthritis. Septic arthritis is bacterial infection of synovium and subsequently all the structure within the joint, which causes intense inflammatory reaction, possibly leading to destruction of articular cartilage and later of the complete Joints. Case Presentation: A diagnosis of septic arthritis was explicitly assigned when a patient had a positive Gram stain or culture finding of joint fluid, purulent joint aspiration drawn from a joint adjacent to a site with known osteomyelitis, focal joint involvement in the setting of bacteremia. If no growth was observed during culture, we presumed a diagnosis of septic arthritis when 2 of the major and 5 of the minor clinical criteria described by Morrey et al. were satisfied and the diagnosis was supported by ultrasonographic findings.Conclusion: The incidence of septic arthritis in children < 1 year is 1.65 per1000 children, 8.37 per 10,000 infants and in neonates its 2.80 per 1000. Males are most commonly affected with male: female being 3: 1. Hip is commonest involved joint. Commonest organism responsible for septic arthritis is Staphylococcus. The major cause of late presentation and/or delayed initiation of definitive management in septic arthritis is handling of the patients by non-orthopaedics specialist initially. Identified risk factors in this study are prematurity, perinatal hypoxia, septicemia, birth trauma and venous catheterization. Most of the clinical improvement occurs during first 6 weeks. Radiological improvement lags behind clinical improvement by 2-4 weeks. Most important prognostic factors for poor outcome are late presentation and /or delayed initiation of definative management.