Swarup Ishaan, LaValva Scott, Shah Ronit, Sankar Wudbhav N
UCSF Benioff Children's Hospital, Oakland, California.
Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
JBJS Rev. 2020 Feb;8(2):e0103. doi: 10.2106/JBJS.RVW.19.00103.
Septic arthritis of the hip is a common and potentially devastating condition in children. Septic arthritis is most commonly caused by Staphylococcus aureus, but other pathogens should be considered on the basis of patient age and presence of risk factors. Diagnosis of septic arthritis is based on history and physical examination, laboratory tests, radiographs, ultrasound, and arthrocentesis. Treatment comprises empiric antibiotics and joint debridement, and antibiotics are subsequently tailored on the basis of culture data, local resistance patterns, and clinical response. Late sequelae of septic arthritis include osteonecrosis, chondrolysis, growth disturbance, subluxation or dislocation, and progressive ankylosis. Surgical treatments to address these issues have been described.
儿童髋关节化脓性关节炎是一种常见且可能具有毁灭性的病症。化脓性关节炎最常见的病因是金黄色葡萄球菌,但应根据患者年龄和危险因素的存在情况考虑其他病原体。化脓性关节炎的诊断基于病史、体格检查、实验室检查、X线片、超声和关节穿刺术。治疗包括经验性抗生素治疗和关节清创术,随后根据培养数据、局部耐药模式和临床反应调整抗生素。化脓性关节炎的晚期后遗症包括骨坏死、软骨溶解、生长障碍、半脱位或脱位以及进行性关节强直。已经描述了针对这些问题的手术治疗方法。