Rai Akash, Chakladar Debrup, Bhowmik Souravi, Mondal Tanushree, Nandy Arnab, Maji Biplab, Hazra Avijit, Mondal Rakesh
Department of Pediatrics, North Bengal Medical College, Darjeeling, India.
Department of Pediatrics, Medical College, Kolkata, India.
Eur J Rheumatol. 2020 Feb;7(Suppl1):S72-S77. doi: 10.5152/eurjrheum.2019.19052.
To delineate the pattern of joint involvement in neonatal septic arthritis, assess the prognosis, and determine significant predictors of unfavorable outcome.
Subjects were recruited through purposive sampling after obtaining parental consent. A detailed history and examination findings with perinatal data were recorded. Ultrasound and magnetic resonance imaging data of affected joints and blood culture and aspirated joint fluid culture data were recorded along with management received. Cases were followed-up every 3 months from discharge up to minimum 12 months. An unfavorable outcome indicated by permanent joint deformity or restricted range of movement of the affected joint, limb length discrepancy, and persistent joint deformity upon radio imaging at the end of the follow-up period were also included.
The hip joint involvement (59.2%) was the commonest with predominance of the monoarticular pattern of affliction (74.4%). An overall outcome was favorable in 70.3% subjects with prompt diagnosis and management. A delay in seeking treatment was found to be an indicator of unfavorable outcome. In addition, disease detection by ultrasound at presentation predicted unfavorable outcome.
Neonatal septic arthritis is a rare disease with predominant hip or knee involvement. Outcome is favorable with early detection and institution of appropriate management. A delay in treatment worsens prognosis.
明确新生儿脓毒性关节炎的关节受累模式，评估预后，并确定不良结局的重要预测因素。
在获得家长同意后，通过目的抽样招募研究对象。记录详细的病史、检查结果及围产期数据。记录受累关节的超声和磁共振成像数据、血培养及关节穿刺液培养数据以及所接受的治疗情况。从出院起每3个月对病例进行随访，至少随访12个月。不良结局包括随访期末影像学检查显示的永久性关节畸形、受累关节活动范围受限、肢体长度差异以及持续性关节畸形。
髋关节受累（59.2%）最为常见，单关节受累模式占主导（74.4%）。70.3%的受试者经及时诊断和治疗后总体结局良好。发现寻求治疗延迟是不良结局的一个指标。此外，就诊时通过超声检测出疾病预示着不良结局。
新生儿脓毒性关节炎是一种罕见疾病，主要累及髋关节或膝关节。早期发现并采取适当治疗，结局良好。治疗延迟会使预后恶化。
