Acute haematogenous septic arthritis of a lumbar facet joint in an otherwise healthy adolescent

Egileak

  • S. García-Mata COMPLEJO HOSPITALARIO DE NAVARRA
  • A. Hidalgo-Ovejero COMPLEJO HOSPITALARIO DE NAVARRA

##plugins.pubIds.doi.readerDisplayName##:

https://doi.org/10.23938/ASSN.0644

Gako-hitzak:

septic arthritis, facet joint, spinal infection, child limp

Laburpena

Facet joint septic arthritis is a rare cause of spinal infection in children with only four cases reported. The transmission pathway is believed to be haematogenous in 72% of cases.

The authors present the case of a 13-year-old boy hospitalised for acute lumbosciatalgia, limp and fever, with pain upon palpation of the paravertebral muscles, a positive Laségue signal and elevated serum inflammatory markers. The initial lumbar computerised tomography (TC) scan revealed no abnormalities in the interapophyseal joints. After improving on treatment with analgesics and antibiotics, he was readmitted one month later due to clinical deterioration, and septic arthritis of left facet joint L3-L4 was confirmed by magnetic resonance imaging (MRI). The patient experienced a full recovery after treatment with systemic antibiotics (cefotaxime-cloxacilin) and rehabilitation.

A high index of suspicion is necessary to diagnose this localization as a manifestation of lumbosciatalgia and/or limp in children. CT-scan or, preferably, MRI is mandatory to confirm this diagnosis.

Keywords. Septic arthritis. Facet joint. Spinal infection. Adolescent. Limp.

##plugins.generic.usageStats.downloads##

##plugins.generic.usageStats.noStats##

##submission.authorBiographies##

##submission.authorWithAffiliation##

Jefe de Sección COT Infantil

##submission.authorWithAffiliation##

Jefe de Servicio COT.

Erreferentziak

BOOS N. Infections of the spine. En: Boos N, Aebi M, editores. Spinal Disorders. Fundamentals of diagnosis and treatment. Berlin: Springer-Verlag, 2008: 1021-1037. https://doi.org/10.1007/978-3-540-69091-7

HERRERO HERRERO JI, GARCÍA APARICIO J. Escherichia coli septic arthritis of a lumbar facet joint following urinary tract infection. Int J Infect Dis 2011; 15: e63-5. https://doi.org/10.1016/j.ijid.2009.11.004

HARRIES LW, WATURA R. Septic arthritis of unilateral lumbar facet joint with contiguous abscess, without prior intervention. BMJ Case Rep 2012; 2: 1-8. https://doi.org/10.1136/bcr.09.2011.4849

MAS-ATANCE J, GIL-GARCÍA MI, JOVER-SÁENZ A, CURIÀ-JOVÉ E, JOVÉ-TALAVERA R, CHARLEZ-MARCO A et al. Septic of a posterior lumbar facet joint in an infant. Spine (Phila Pa 1976) 2009; 34: E465-468. https://doi.org/10.1097/BRS.0b013e3181a4e64b

SMIDA M, LEJRI M, KANDARA H, SAYED M, BEN CHEHIDA F, BEN GHACHEM M. Septic arthritis of a lumbar facet joint case report and review of the literature. Acta Orthop Belg 2004. 70: 290-294.

HEENAN SD, BRTON J. Septic arthritis in a lumbar facet joint: a rare cause of an epidural abscess. Neuroradiology 1995; 37: 462-464. https://doi.org/10.1007/BF00600094

FRENCH R, PURUSHOTHAMAN B, ROYSAM GS, LAKSHMANAN P. Pediatric facet joint septic arthritis. Spine J 2015; 15: 1686-1688. https://doi.org/10.1016/j.spinee.2015.02.006

STECHER JM, EL-KHOURY GY, HITCHON PW. Cervical facet joint septic arthritis: a case report. Iowa Orthop J 2010; 30: 182-187.

KLEKOT D, ZIMNY A, CZAPIGA B, SĄSIADEK M. Isolated septic facet joint arthritis as a rare cause of acute and chronic low back pain - a case report and literature review. Pol J Radiol 2012; 77: 72-76. https://doi.org/10.12659/PJR.883634

KRISHNAN V, AMRITANAND R, SUNDARARAJ GD. Methicillin-resistant Staphylococcus aureus as a cause of lumbar facet joint septic arthritis: a report of two cases. J Bone Joint Surg Am 2010; 92: 465-468. https://doi.org/10.2106/JBJS.H.01888

PAPALIODIS DN, ROBERTS TT, RICHARDSON NG, LAWRENCE JB. Spontaneous septic arthritis of the lumbar facet caused by methicillin-resistant Staphylococcus aureus in an otherwise healthy adolescent. Am J Orthop (Belle Mead NJ) 2014; 43: 325-327.

SIMON EL, GAIR L, KOVACS M. Meningoencephalitis caused by septic arthritis of a lumbar facet joint in a patient without fever or risks factors. Am J Emerg Med 2016; 34: 762.e1-2. https://doi.org/10.1016/j.ajem.2015.08.028

KITOVA-JOHN MB, AZIM-ARAGHI A, SHEIKH FT, KITOV BD. Idiopathic septic arthritis of a lumbar facet joint associated with paraspinal abscess. BMJ Case Rep 2015. https://doi.org/10.1136/bcr-2015-211135

RAEYMAECKERS S, NIEBOER K, DE MEY J. Progressive quadriplejia resulting from septic facet joint arthritis. JBR-BTR 2015; 98: 58. https://doi.org/10.5334/jbr-btr.764

KIM SY, HAN SH, JUNG MW, HONG JH. Generalized infection following facet joint injection -A case report-. Korean J Anesthesiol 2010; 58: 401-404. https://doi.org/10.4097/kjae.2010.58.4.401

HALPIN DS, GIBSON RD. Septic arthritis of a lumbar facet joint. J Bone Joint Surg 1987; 69-B: 457-459. https://doi.org/10.1302/0301-620X.69B3.3584201

Argitaratuta

2019-08-23

Zenbakia

Atala

Notas clínicas

##plugins.generic.recommendByAuthor.heading##