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AB0906 Pyogenic septic arthritis: is there a difference when germ is not identified?
  1. H Sahli1,
  2. M Sahli1,
  3. R Tekaya2,
  4. O Saidane2,
  5. R Khalfallah1,
  6. I Mahmoud2,
  7. L Abdelmoula2
  1. 1Rheumatology Departement, Mohamed Taher Maamouri University Hospital, nabeul
  2. 2Rheumatology Departement, Charles Nicolle Hospital, tunis, Tunisia

Abstract

Background Pyogenic septic arthritis (PSA), defined by the presence of living microorganisms in the affected joint, is a therapeutic emergency. Germ isolation is a primordial step in the diagnostic and therapeutic approach.

Objectives The aim of this study was to study the differences between PSA with positive and negative bacteriology.

Methods This is a retrospective study which included medical records of patients treated for PSA in a rheumatology department over seventeen years. The epidemioclinical and paraclinical data were recorded. We used the SPSS 11.5 for the statistical analysis to compare patients with (group 1) and without an isolated causative agent (group 2).

Results We evaluated 49 patients with a diagnosis of PSA. They were 26 (53.1%) men and 23 (46.9%) women. The average age was 55+/-18.7 years (ranging from 15 to 95 years). Comorbidities were observed in 31 (63.3%) patients. The onset of symptoms was acute in 37 (75.5%) patients and progressive in 12 (24.5%) patients. The most common symptoms were joint pain and stiffness (100%) and functional impotence (87.8%). All patients were treated with double or triple antibiotics. Among the studied patients, 27 (55.1%) had negative culture results. Statistical analysis used to compare cases with an isolated pathogen to those cases without an isolated pathogen, noted female predominance in group 2 but there was no statistically significant difference (p=0.252). Patients in group 1 and group 2 had a comparable mean age (p=0.08). Patients in both groups had comparable risk factors for PSA (p=0.549). Acute onset was more common in group 2 (51.4% versus 48.6%) but without a significant difference (p=0.507). Biological inflammatory syndrome was more frequent in group 2 but with no statistically significant difference (p=0.235). The study of the appearance of the synovial fluid did not demonstrate a statistically significant difference between the two groups (p=0.125). The abnormalities of standard x-rays were similar in both groups (45.2% in group 1 versus 54.8% in group 2, (p=1)). The statistical study of all other variables didn't show differences between the two groups.

Conclusions PSA was not associated with major differences if the germ was or not isolated.

Disclosure of Interest None declared

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