We report a rare case of septic arthritis in a healthy child caused by Salmonella enteritidis. No predisposing factor was detected. Salmonella enteritidis was isolated from the infected joint tissue obtained following surgical drainage. Based on the culture and sensitivity report, he was treated with a 6-week course of antibiotic. He improved dramatically without any detrimental sequelae at end of one year.
Septic arthritis of the hip in children represents a serious disorder with unfavourable long-term sequelae. In neonates, a poor hip outcome is expected especially if the treatment was delayed. Late sequelae can lead to structural joint damage and instability, causing deformity and dislocations which ultimately may result in limb length discrepancy, early degenerative changes and limited range of motion. Surgery at the appropriate time can improve the hip condition and functional outcome. Previous classifications of post septic hip sequelae are useful guides for treatment, but did not discuss one particular group of patient. This group-septic hip dislocation with a preserved femoral head, has recently been described as a distinct entity. This report highlights an 11-year follow-up of a 2-year-old child who had a successful outcome following open reduction and varus derotation
osteotomy for a septic hip dislocation with a preserved femoral head.
Keywords: septic arthritis, hip dislocation, child, infection
Slipped capital femoral epiphysis (SCFE) is a relatively uncommon hip disorder in adolescents and its prevalence in Malaysia has not been studied. This retrospective study is undertaken to provide an overview of a 12-year review of SCFE treated in our institution. Fourteen patients (19 hips) with slipped capital femoral epiphysis (SCFE) admitted to Hospital UKM from 1990 to 2002 were reviewed with respect to demographic profile, functional outcome according to the Iowa Hip Score, and complications. There were ten boys (average age, 12.5 years) and four girls (average age, 12 years). Eight were Malays and six were Indians. The average body mass index was 26.1 verweight). The left hips (11 hips) were affected more than the right hips (eight hips). Five patients had bilateral slips. Thirteen hips were considered stable while the other six hips were unstable. The majority of cases were moderate slips (12 hips), four hips had severe slips while three hips had mild slips. Several methods of treatment were instituted. These include in situ cannulated screw fixation (11 hips), Knowles pin fixation (three hips) and gentle closed manipulative reduction with cannulated screw fixation (three hips). One patient with bilateral slips refused surgical treatment. Based on the Iowa Hip Score, most patients (nine) had satisfactory results (excellent or good), three had fair results while one patient had a poor result. Avascular necrosis developed in five hips while chondrolysis occurred in one hip. In situ cannulated screw fixation is the treatment of choice. SCFE is an uncommon condition in Malaysia.