Umrani Salil, Al-Mufargi Yaqoub
Department of Orthopaedics, Armed Forces Hospital, Salalah, Oman.
Sultan Qaboos Univ Med J. 2018 Nov;18(4):e545-e548. doi: 10.18295/squmj.2018.18.04.021. Epub 2019 Mar 28.
Septic arthritis is a surgical emergency requiring prompt drainage of the accumulation of pus in the joint. We report an eight-year-old boy who was referred to the Armed Forces Hospital, Salalah, Oman, in 2016 with limping and pain in his right hip along with an abduction deformity. He was initially diagnosed with synovitis and underwent conservative management. However, two weeks later, he presented to another centre due to persistent pain. Magnetic resonance imaging was suggestive of septic arthritis or osteomyelitis. Eight weeks later, the patient presented again to the Armed Forces Hospital. An arthrotomy was performed, during which an amount of what appeared to be frank pus was drained; however, cultures of the intraoperative samples returned no growth. A histopathological analysis revealed an osteosarcoma. The patient was subsequently referred elsewhere and underwent neoadjuvant chemotherapy and limb salvage surgery. Several months later, he relapsed and developed extensive pulmonary metastasis and died as a result of progressive deterioration.
化脓性关节炎是一种外科急症，需要及时引流关节内积聚的脓液。我们报告一例八岁男孩，2016年因右髋跛行、疼痛伴外展畸形被转诊至阿曼萨拉拉的武装部队医院。他最初被诊断为滑膜炎并接受了保守治疗。然而，两周后，由于持续疼痛，他前往了另一家医疗机构。磁共振成像提示为化脓性关节炎或骨髓炎。八周后，该患者再次就诊于武装部队医院。进行了关节切开术，术中引流了大量看似脓性的液体；然而，术中样本培养未发现细菌生长。组织病理学分析显示为骨肉瘤。该患者随后被转诊至其他地方，接受了新辅助化疗和保肢手术。几个月后，他复发并出现广泛的肺转移，最终因病情逐渐恶化而死亡。
