PMID: 9446091Jan 31, 1998Paper

Coxitis in the newborn infant and infant. Diagnosis and therapy

Der Orthopäde
K Parsch, E Savvidis

Abstract

From 198 o 1996 (12 years) we saw 24 neonates and small infants with septic arthritis of the hip joint. A minority of these infants was simultaneously affected by osteomyelitis of the femoral neck or the acetabulum. Clinical signs are a painful leg, pseudoparalysis, uneasiness and refusal to drink. Quantitative measurements of C-reactive protein (CRP) are more reliable then leucocyte count and sedimentation rate. Ultrasound images yield early information about capsular swelling and septic effusion; in late cases US can visualize femoral neck necrosis. Emergency arthrotomy to relieve the joint from septic effusion, bacteriological specimens and capsular biopsy are mandatory. Intravenous application of a second-generation cephalosporin as antibiotic has proven effective. We have been using cefuroxim for the past 10 years, changed if necessary according to the antibiogram. Parenteral antibiotic treatment is continued for an average of 3 weeks, followed by oral treatment for another 3 weeks. CRP normalisation monitors the cure from the disease. Our 24 cases included 7 with group B streptococci 2 with Staphylococcus aureus, 2 with Staphylococcus epidermidis and 2 with Escherichia coli. In 8 cases no germs could be cultured; 6 of the...Continue Reading

Citations

Mar 12, 2010·Journal of Pediatric Orthopedics. Part B·Markus PääkkönenPentti E Kallio
Jun 27, 2008·Journal of Pediatric Orthopedics·Edilson Forlin, Carlo Milani
May 29, 2003·Clinical Orthopaedics and Related Research·Alfonso ManzottiMaurizio A Catagni

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