Munigangaiah Sudarshan, O'Sullivan Theresa A, Lenehan Brian
Department of Trauma & Orthopaedic Surgery, Galway University Hospital, Galway, Ireland.
Department of Trauma & Orthopaedic Surgery, Midwestern Regional Hospital Limerick, Dooradoyle, Co Limerick, Ireland.
J Nat Sci Biol Med. 2014 Jul;5(2):485-7. doi: 10.4103/0976-9668.136278.
Osteoarthritis of knee is one of the common problems in elderly population. Intraarticular corticosteroid injection is a conservative management modality in osteoarthritis of knee. Septic arthritis is an infective complication of intraarticular corticosteroid injection. Septic arthritis in rheumatoid arthritis patients have worse prognosis because of delay in diagnosis. A higher rate of infectious complications following intraarticular injection is expected in immunocompromised and rheumatoid patients. We would like to report an extremely rare case of simultaneous bilateral knee septic arthritis after bilateral knee intraarticular steroid injection in a rheumatoid arthritis patient. Patient was treated successfully with multiple bilateral knee arthroscopic washouts and long-term intravenous antibiotics. This case report emphasizes the increased risk of infection in rheumatoid arthritis patients and a risk benefit assessment on individual basis before carrying out intraarticular steroid injection. Patient should be aware of this increased risk of infection.
膝关节骨关节炎是老年人群中的常见问题之一。关节内注射皮质类固醇是膝关节骨关节炎的一种保守治疗方式。化脓性关节炎是关节内注射皮质类固醇的一种感染性并发症。类风湿关节炎患者发生的化脓性关节炎由于诊断延迟,预后较差。免疫功能低下和类风湿患者关节内注射后感染并发症的发生率较高。我们想报告一例极为罕见的病例,一名类风湿关节炎患者双侧膝关节内注射类固醇后同时发生双侧膝关节化脓性关节炎。患者通过多次双侧膝关节关节镜冲洗和长期静脉使用抗生素成功治愈。本病例报告强调了类风湿关节炎患者感染风险增加,以及在进行关节内类固醇注射前应基于个体情况进行风险效益评估。患者应知晓这种感染风险增加的情况。