Skeete Kshamata, Hess Erik P, Clark Tod, Moran Steven, Kakar Sanjeev, Rizzo Marco
Department of Orthopedic Surgery, Division of Hand Surgery, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
J Hand Surg Am. 2011 Mar;36(3):469-74. doi: 10.1016/j.jhsa.2010.10.033. Epub 2010 Dec 24.
To determine the cumulative prevalence of septic arthritis presenting to the emergency department of an academic medical center and evaluate the use of clinical data to diagnose infection versus inflammation.
We conducted a records review of a single institution with 80,000 annual emergency room visits. We included a consecutive series of patients with suspected wrist infection from January 1, 2007, to December 31, 2008. Adults complaining of atraumatic wrist pain with either erythema or swelling on physical examination or a final diagnosis of septic arthritis, gout, pseudogout, cellulitis, wrist hematoma/edema, or wrist arthritic flare were suspected to have infection. We collected data using a standardized data abstraction form.
We reviewed 804 patient records. A total of 104 patients meeting inclusion criteria for suspected wrist joint infection during the 2-year study period were included. Mean age was 62.5 years (SD, 20.2 y); 63 were men. There were 12 patients with a history of gout, 4 with a history of pseudogout, and 19 with a history of diabetes. Wrist arthrocentesis was performed in 31 patients, and 11 underwent surgical treatment. There were 16 patients with a final diagnosis of gout, 11 with pseudogout, 43 with cellulitis, 13 with upper extremity hematoma/edema, and 15 with wrist arthritic flare. The cumulative prevalence of septic arthritis was 5%.
In this series of emergency department patients with suspected wrist joint infection, gout, pseudogout, and cellulitis were the most common etiologies. The cumulative incidence of septic wrist arthritis was low.
确定在一所学术医疗中心急诊科就诊的脓毒性关节炎的累积患病率，并评估利用临床数据诊断感染与炎症的情况。
我们对一家年急诊量达80000例的单一机构进行了记录回顾。纳入了2007年1月1日至2008年12月31日期间一系列连续的疑似腕部感染患者。主诉无创伤性腕部疼痛且体格检查有红斑或肿胀的成年人，或最终诊断为脓毒性关节炎、痛风、假性痛风、蜂窝织炎、腕部血肿/水肿或腕关节炎发作的患者被怀疑有感染。我们使用标准化的数据提取表收集数据。
我们回顾了804份患者记录。在为期2年的研究期间，共有104例符合疑似腕关节感染纳入标准的患者被纳入。平均年龄为62.5岁（标准差，20.2岁）；63例为男性。有12例患者有痛风病史，4例有假性痛风病史，19例有糖尿病病史。31例患者进行了腕关节穿刺，11例接受了手术治疗。最终诊断为痛风的有16例，假性痛风11例，蜂窝织炎43例，上肢血肿/水肿13例，腕关节炎发作15例。脓毒性关节炎的累积患病率为5%。
在这一系列疑似腕关节感染的急诊科患者中，痛风、假性痛风和蜂窝织炎是最常见的病因。腕部脓毒性关节炎的累积发病率较低。
