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Use este identificador para citar ou linkar para este item: https://repositorio.ufba.br/handle/ri/12810
Tipo: Artigo de Periódico
Título: Septic arthritis in adults with sickle cell disease often is associated with osteomyelitis or osteonecrosis
Título(s) alternativo(s): Clinical Orthopaedics and Related Research
Autor(es): Hernigou, Philippe
Daltro, Gildásio de Cerqueira
Lachaniette, Charles Henri Flouzat
Roussignol, Xavier
Poignard, Alexandre
Autor(es): Hernigou, Philippe
Daltro, Gildásio de Cerqueira
Lachaniette, Charles Henri Flouzat
Roussignol, Xavier
Poignard, Alexandre
Abstract: Background: Septic arthritis is a known complication of sickle cell disease (SCD) in children, and the association with osteomyelitis and osteonecrosis has been described. However, it is unclear whether this association applies to adults. Questions/Purposes We therefore asked whether septic arthritis is a frequent complication in adults with SCD and whether it also is associated with osteomyelitis or osteonecrosis. Methods We retrospectively reviewed the charts of 2000 consecutive adult patients diagnosed with SCD and recorded symptoms, select findings during physical examination, laboratory data, and select radiographic CT, and MRI observations. Results Fifty-nine of the 2000 patients (3%) had septic arthritis, 56 of the 59 patients had hemoglobin SS. Thirty-six of the 59 infections (61%) were in the hip. The most frequent findings were pain, swelling, fever greater than 38.2°C (71% of cases), a leukocyte count exceeding 15,000/mm3 (range, 7900–32,300/mm3), a Westergren sedimentation rate greater than 24 mm/hour, and C-reactive protein exceeding 20 mg/L. Cultures were positive in 96% of the joint aspirates. Staphylococcus and Gram-negative infection predominated; no patients had Salmonella joint infections. Preexisting factors of bacterial arthritis included osteonecrosis (29 patients) and osteomyelitis (37 cases) in childhood. Diabetes, rheumatoid arthritis, glucocorticoids, and immunoparesis related to medical treatment by hydroxyurea were associated comorbidities. CT and MRI confirmed the diagnosis of associated osteonecrosis or osteomyelitis and allowed joint aspiration and detection of soft tissue abscess. Conclusions: The incidence of septic arthritis in adults with SCD is low, but often is associated with osteomyelitis or osteonecrosis.
Palavras-chave: Osteonecrosis
Osteomyelitis
Hydroxyurea
URI: http://www.repositorio.ufba.br/ri/handle/ri/12810
Data do documento: 2010
Aparece nas coleções:Artigo Publicado em Periódico (Faculdade de Medicina)

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