Wurm Lennard M, Andresen Julian R, Reinke Justyna, Poddubnyy Denis, Ertel Wolfgang, Jagielski Michal W
Department of Traumatology and Reconstructive Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.
Medical Faculty Heinrich-Heine University and University Hospital Düsseldorf, Düsseldorf, Germany.
J Surg Case Rep. 2023 Apr 12;2023(4):rjad168. doi: 10.1093/jscr/rjad168. eCollection 2023 Apr.
Procalcitonin (PCT) and C-reactive protein (CRP) are considered markers used in clinical practice to differentiate bacterial infections from autoimmune origin. Here we evaluate a rare case of a male patient diagnosed with juvenile idiopathic arthritis. The patient presented repeatedly to our department with atraumatic femoral head necrosis, traumatic medial femoral neck fracture and peri-implant femoral fracture. While undergoing repeated surgical interventions including a removal of osteosynthesis material and total endoprosthesis of his right hip including double subtrochanteric osteotomy, the patient developed drastically increasing infection parameters of PCT and CRP. After a completely inconspicuous revision we revealed the untypical genesis of a rheumatic cause. Consequently, we emphasize this etiology to be considered in further decision making for trauma surgery.
降钙素原（PCT）和C反应蛋白（CRP）被认为是临床实践中用于区分细菌感染和自身免疫性病因的标志物。在此，我们评估了一例罕见的男性青少年特发性关节炎患者。该患者因非创伤性股骨头坏死、创伤性股骨内侧颈骨折和植入物周围股骨骨折反复前来我院就诊。在接受包括取出内固定材料和右侧髋关节全关节置换术（包括双侧转子下截骨术）在内的多次手术干预期间，患者降钙素原（PCT）和C反应蛋白（CRP）的感染参数急剧上升。在一次完全无异常的翻修手术后，我们发现了风湿性病因的非典型起源。因此，我们强调在创伤外科的进一步决策中应考虑这种病因。
