Summary
Fourteen neonates with septic arthritis of the hip, which had been diagnosed late, were reviewed with the aim of establishing the difficulties of making an early diagnosis. The history, physical signs, blood tests and examination of the synovial fluid are the most important guidelines. Radiography was not helpful as less than 50% of cases show early signs, most often a joint effusion. Early diagnosis and surgical drainage are necessary to avoid permanent damage to the cartilaginous femoral head.
Résumé
Les auteurs ont revu 14 cas d'arthrite septique de la hanche chez des nouveaux-nés dans l'intention de déterminer les facteurs ayant retardé le diagnostic précoce. L'anamnèse, l'examen clinique, les tests sanguins et l'examen du liquide synovial sont les éléments fondamentaux du diagnostic. L'examen radiologique est de moindre importance puis qu'il ne montre de signes précoces que dans moins de 50% des cas, à savoir le plus souvent un élargissement de l'interligne articulaire. Un diagnostic précoce suivi d'un drainage chirurgical sont les mesures les plus importantes pour éviter la destruction de la tête fémorale dans les infections de hanche à la période néo-natale.
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Vidigal, E.C., Jácomo, A.D. Early diagnosis of septic arthritis of the hip in neonates. International Orthopaedics 18, 189–192 (1994). https://doi.org/10.1007/BF00192478
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DOI: https://doi.org/10.1007/BF00192478