Wall Christopher, Donnan Leo
MBBS, BMedSc, Orthopaedic Registrar, Department of Orthopaedics, The Royal Children's Hospital Melbourne, Parkville, VIC.
Aust Fam Physician. 2015 Apr;44(4):213-5.
Septic arthritis in children is an orthopaedic emergency that has serious consequences if not diagnosed promptly and treated effectively. The presenting symptoms include pain, non-weight bearing and fever. Inflammatory markers are raised and ultra-sonography demonstrates a joint effusion.
The purpose of this article is to provide an overview of septic arthritis in children.
Definitive treatment involves surgical drainage and lavage of the joint, followed by high-dose, empirical, intravenous (IV) antibiotics. Treatment is tailored to the causative organism, if this is identified. For an uncomplicated case of septic arthritis, 2 days of IV antibiotics followed by a 3-week course of oral antibiotics is usually sufficient. Long-term follow-up is necessary to monitor for sequelae of septic arthritis, including cartilage damage, growth disturbance and avascular necrosis of the femoral head.
儿童化脓性关节炎是一种骨科急症，如果不能及时诊断和有效治疗会产生严重后果。其表现症状包括疼痛、不能负重和发热。炎症标志物升高，超声检查显示关节积液。
本文旨在概述儿童化脓性关节炎。
明确的治疗包括关节的手术引流和灌洗，随后给予大剂量经验性静脉抗生素治疗。如果确定了致病微生物，则根据该微生物进行治疗。对于单纯性化脓性关节炎病例，静脉使用抗生素2天，随后口服抗生素3周通常就足够了。需要进行长期随访以监测化脓性关节炎的后遗症，包括软骨损伤、生长障碍和股骨头缺血性坏死。
