• Clinics in Shoulder and Elbow
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• v.13 no.1
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• pp.106-110
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• 2010

Purpose: We report a case of pyogenic arthritis of the shoulder secondary to infective endocarditis. Materials and Methods: A 70 year-old male who had suffered from pyogenic arthritis of the left shoulder secondary to infective endocarditis was treated with artificial valvuloplasty, arthroscopic synovectomy and drainage. Results: Infection was cured and the patient achieved a good functional outcome. Conclusion: Pyogenic arthritis of the shoulder is rarely associated with infective endocarditis. However, if the symptoms are misdiagnosed as musculoskeletal symptoms associated with infective endocarditis, serious complications may arise. As such, musculoskeletal symptoms associated with infective endocarditis should be paid careful attention.

• Journal of the Korean Arthroscopy Society
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• v.15 no.1
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• pp.28-31
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• 2011

Pyogenic arthritis of the shoulder is very rare disease in infant. Early diagnosis and proper treatment are very important prognostic factors. We treated a 10-month-old infant who was suffering pyogenic arthritis of the shoulder by arthroscopic irrigation and synovectomy with direct inspection. Finally, satisfactory result was achieved without any major scar or complications.

• Journal of the Korean Arthroscopy Society
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• v.12 no.2
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• pp.129-133
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• 2008

Although the incidence of tuberculosis has been decreased due to new anti-tuberculous agents, improved socioeconomic status and development of multimodal preventive methods, in recent that is increased due to low vaccination rate and appearance of multidrug resistence organism. And the incidence of pyogenic shoulder joint arthritis is increasing due to frequent injection therapy as primary treatment. We have managed the mixed shoulder joint arthritis-pyogenic and tuberculous-with arthroscopic debridement and antituberculous medication successfully and then we report this case with relevant literatures.

• Journal of the Korean Arthroscopy Society
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• v.13 no.1
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• pp.72-76
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• 2009

Two diabetes mellitus patients treated by arthroscopy and associated procedure for an infection after arthroscopic rotator cuff repair were involved. The time interval from rotator cuff repair to symptom development was 18 days in average and arthroscopic debridement and associated procedure for infection applied in average 65 days after symptom development. Patient evaluation was done according to the KSS, ASES, UCLA and Constant Score. We used antibiotics for average 22.5 days after arthroscopic debridement and associated procedure, the infection was treated in average 4 months. At final follow-up, the mean KSS score was 82 points, the mean UCLA score was 33 points, the mean ASES score was 91 points, the mean Constant score was 71 points. All infections following arthroscopic rotator cuff repair were cured by arthroscopy and associated procedure. ROM and functional results were much improved, the pain and satisfaction were also much improved.

• Clinics in Shoulder and Elbow
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• v.13 no.1
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• pp.99-105
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• 2010

Purpose: Here we report clinical results for surgical treatment of 2 cases of pyogenic arthritis and 1 case of tubercular arthritis, which only rarely develops in the sternoclavicular joint. Materials and Methods: From September 2003 to September 2008, we did early marginal resection and thorough debridement of osteomyelitis of the sternum and distal clavicle in 3 patients and evaluated clinical results after short-term follow up. Results: All 3 patients were satisfied with their clinical results and none had any recurrences according to follow up X-rays and laboratory datas. The follow up MRI showed bone edema in the distal clavicle and proximal sternum and a little fluid retention around the sternoclavicular joint. Conclusion: Even though diagnosis of these diseases are made earlier, infection of the adjacent bone and osteomyelitis could already have developed. We did early marginal resection and thorough debridement of osteomyelitis of the sternum and distal clavicle and achieved satisfactory results.

• Clinics in Shoulder and Elbow
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• v.11 no.2
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• pp.189-192
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• 2008

Sternoclavicular septic arthritis is a rare condition and it is usually related to predisposing conditions like intravenous drug abuse, diabetic mellitus, trauma and so on. A delayed diagnosis of this disease may cause severe complications like mediastinitis and chest wall abscess. Computed tomography or magnetic resonance imaging is needed to evaluate the complications. If the above complications are present, then joint resection should be considered. We report here on a case of a 52-year-old man who was diagnosed with primary sternoclavicular septic arthritis and he had no predisposing conditions. The pathogen on the aspiration-culture was S. aureus and it was susceptible to cefminox. The patient was cured with administering only antibiotic therapy for 6 weeks; intravenous cefminox therapy for 4 weeks followed by oral cefminox therapy for 2 weeks.

• Pediatric Infection and Vaccine
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• v.18 no.1
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• pp.31-39
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• 2011

Purpose : This study was performed for the purpose of finding causative organisms and clinical features of septic arthritis or acute osteomyelitis in children. Methods : The study involved a retrospective review of the medical records of 63 microbiologically confirmed cases of acute pyogenic arthritis and osteomyelitis. All of the cases were brought about by community-associated infections and managed at the Seoul National University Children's Hospital or Seoul National University Bundang Hospital from June 2003 to July 2009. Results : The median age of all cases was 60 months and there were 35 males and 28 females. Major involved joints included the hip joint (15 cases), knee joint (7 cases), shoulder joint (4 cases), and elbow joint (4 cases). Also, major involved bones included the femur (20 cases), tibia (13 cases), humerus (7 cases), and radius (7 cases). Staphylococcus aureus was the most commonly identified causative organism, accounting for 49 cases (77.8%). Of the 49 isolates of S. aureus, methicillin-resistant S. aureus (MRSA) accounted for 8 cases (16.3%). Group B streptococcus spp. (GBS) and Salmonella spp. accounted for 3 cases, respectively. Nafcillin or cefazolin was often prescribed as an initial empirical antibiotic. There were 9 cases that were managed by a regimen that included vancomycin as the first choice. Fifty four cases (85.7%) recovered without any complications. Methicillin-sensitive S. aureus (MSSA), responsible for 41 cases, caused chronic complications in 3 cases. Of 8 cases caused by MRSA, 1 case showed chronic complication. There were no fatal cases. Conclusion : S. aureus remains the most common organism causing acute pyogenic arthritis and osteomyelitis of childhood acquired in the community. The high prevalence of methicillin resistance among S. aureus should be considered carefully in the selection of initial empirical antibiotics.

• Clinics in Shoulder and Elbow
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• v.8 no.2
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• pp.110-116
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• 2005

Purpose: Urgent diagnosis and treatment of the septic arthritis is required. The purpose of this study is to review to correlate preoperative MRI findings with arthroscopic findings in septic arthritis of the glenohumeral joint. Materials and Methods: Eleven patients with acute septic arthritis of the glenohumeral joint were treated with combination of arthroscopic lavage, debridement, and systemic antibiotics. The arthroscopic staging of infection was made based on the modified criteria of $G\"{a}chter$ and five major findings of MRI were marked in each stage of septic shoulder. Results: Bone and cartilage erosion was the end stage finding and two patients with all five positive findings had failed with arthroscopic treatment. Reactive bone marrow edema was evident in the greater tuberosity. Joint effusion, synovial thickening and soft tissue edema were rather non-specific finding and presented in all stages of septic shoulder. Conclusion: Diffuse marrow edema with metaphyseal cyst formation in the preoperative MRI implied advanced stage of septic arthritis, which may fail with arthroscopic debridement.

• Clinics in Shoulder and Elbow
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• v.6 no.2
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• pp.167-172
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• 2003

Olecranon bursitis rarely Progresses to septic arthritis. In our case, the 24 year old woman was visited due to progressing right elbow pain, despite antibiotic treatment of chronic olecranon bursitis caused by elbow laceration 2 months ago. Pus draining sinus, localized heating and swelling could be seen on physical examination. Septic arthritis and pathologic fracture was diagnosed under arthroscopic examination. Arthroscopic irrigation and synovectomy for elbow joint, olecranon bursectomy and curettage of olecranon bone was done. In the operation field, the elbow and draining sinus over olecranon was communicated each other on saline irrigation test. The patient was treated for 3 weeks with intravenous antibiotics. At postoperative 4 weeks, bone graft was done. The possibility of chronic osteomyelitis and septic arthritis must be considered in a patient with chronic olecranon bursitis.