Septic Arthritis and Related Conditions

A special issue of Children (ISSN 2227-9067).

Deadline for manuscript submissions: closed (1 April 2021) | Viewed by 17234

Special Issue Editors


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Guest Editor
Pediatric Rheumatology, Anna Meyer Children’s University Hospital, 50139 Florence, Italy
Interests: juvenile idiopathic arthritis; systemic lupus erythematosus; pediatric vasculitis
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Guest Editor
Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
Interests: autoinflammatory diseases; uveitis; Kawasaki disease, osteoporosis

Special Issue Information

Dear Colleagues,

Septic arthritis in pediatrics is a true emergency, requiring prompt diagnosis and treatment in order to avoid adverse sequalae in the growing skeleton. However, this condition may present with an indolent course and vague features, making it difficult to easily identify. Many different diseases should be considered in the differential diagnosis since, although clinically similar, their therapy and prognosis may differ. The clinical presentation with the peculiarities in different age groups, the differential diagnosis, imaging studies, treatment, and prognosis will be the focus of this Issue.

Dr. Teresa Giani
Prof. Rolando Cimaz
Guest Editors

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Keywords

  • infections 
  • arthritis 
  • JIA 
  • chronic recurrent multifocal osteomyelitis 
  • differential diagnosis 
  • osteomyelitis 
  • septic arthritis

Published Papers (5 papers)

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Editorial

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3 pages, 167 KiB  
Editorial
Septic Arthritis and Related Conditions
by Teresa Giani and Rolando Cimaz
Children 2022, 9(5), 751; https://0-doi-org.brum.beds.ac.uk/10.3390/children9050751 - 19 May 2022
Cited by 1 | Viewed by 1300
Abstract
Arthritis is a common condition that any pediatrician may have to deal with [...] Full article
(This article belongs to the Special Issue Septic Arthritis and Related Conditions)

Review

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10 pages, 749 KiB  
Review
Acute Arthritis in Children: How to Discern between Septic and Non-Septic Arthritis?
by Lisa Gamalero, Giovanna Ferrara, Teresa Giani and Rolando Cimaz
Children 2021, 8(10), 912; https://0-doi-org.brum.beds.ac.uk/10.3390/children8100912 - 13 Oct 2021
Cited by 9 | Viewed by 4265
Abstract
The term septic arthritis refers to an infection of the synovial space. This is an infrequent condition in healthy children, but it should be considered a medical emergency potentially leading to irreversible articular damage. Therefore, prompt diagnosis and antimicrobial treatment play a crucial [...] Read more.
The term septic arthritis refers to an infection of the synovial space. This is an infrequent condition in healthy children, but it should be considered a medical emergency potentially leading to irreversible articular damage. Therefore, prompt diagnosis and antimicrobial treatment play a crucial role in improving the prognosis. Although septic arthritis is the most common cause of acute arthritis, many other diseases may mimic a similar clinical picture, constituting a diagnostic challenge for the clinician who first approaches the patient. Herein we analyze the main features of septic arthritis, offering an overview of the main conditions involved in the differential diagnosis and suggesting a diagnostic workup plan. Full article
(This article belongs to the Special Issue Septic Arthritis and Related Conditions)
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15 pages, 566 KiB  
Review
Juvenile Idiopathic Arthritis Associated Uveitis
by Emil Carlsson, Michael W. Beresford, Athimalaipet V. Ramanan, Andrew D. Dick and Christian M. Hedrich
Children 2021, 8(8), 646; https://0-doi-org.brum.beds.ac.uk/10.3390/children8080646 - 27 Jul 2021
Cited by 13 | Viewed by 3502
Abstract
Juvenile idiopathic arthritis (JIA) is the most common childhood rheumatic disease. The development of associated uveitis represents a significant risk for serious complications, including permanent loss of vision. Initiation of early treatment is important for controlling JIA-uveitis, but the disease can appear asymptomatically, [...] Read more.
Juvenile idiopathic arthritis (JIA) is the most common childhood rheumatic disease. The development of associated uveitis represents a significant risk for serious complications, including permanent loss of vision. Initiation of early treatment is important for controlling JIA-uveitis, but the disease can appear asymptomatically, making frequent screening procedures necessary for patients at risk. As our understanding of pathogenic drivers is currently incomplete, it is difficult to assess which JIA patients are at risk of developing uveitis. Identification of specific risk factors for JIA-associated uveitis is an important field of research, and in this review, we highlight the genomic, transcriptomic, and proteomic factors identified as potential uveitis risk factors in JIA, and discuss therapeutic strategies. Full article
(This article belongs to the Special Issue Septic Arthritis and Related Conditions)
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13 pages, 788 KiB  
Review
Chronic Nonbacterial Osteomyelitis in Children
by Aikaterini Koryllou, Manel Mejbri, Katerina Theodoropoulou, Michael Hofer and Raffaella Carlomagno
Children 2021, 8(7), 551; https://0-doi-org.brum.beds.ac.uk/10.3390/children8070551 - 25 Jun 2021
Cited by 13 | Viewed by 3492
Abstract
Chronic nonbacterial osteomyelitis (CNO) is an auto-inflammatory bone disorder with a wide spectrum of clinical manifestations, from unifocal to multifocal lesions. When it manifests with multifocal lesions, it is also referred to as chronic recurrent multifocal osteomyelitis (CRMO). CNO/CRMO can affect all age [...] Read more.
Chronic nonbacterial osteomyelitis (CNO) is an auto-inflammatory bone disorder with a wide spectrum of clinical manifestations, from unifocal to multifocal lesions. When it manifests with multifocal lesions, it is also referred to as chronic recurrent multifocal osteomyelitis (CRMO). CNO/CRMO can affect all age groups, with the pediatric population being the most common. Patients may present with systemic inflammation, but there is no pathognomonic laboratory finding. Magnetic resonance imaging (MRI) is the gold standard radiological tool for diagnosis. In the absence of validated diagnostic criteria, CNO/CRMO remains an exclusion diagnosis. Bone biopsy does not show a specific disease pattern, but it may be necessary in unifocal or atypical cases to differentiate it from malignancy or infection. First-line treatments are non-steroidal anti-inflammatory drugs (NSAIDs), while bisphosphonates or TNF-α blockers can be used in refractory cases. The disease course is unpredictable, and uncontrolled lesions can complicate with bone fractures and deformations, underlying the importance of long-term follow-up in these patients. Full article
(This article belongs to the Special Issue Septic Arthritis and Related Conditions)
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Other

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7 pages, 708 KiB  
Case Report
Pediatric Septic Arthritis of the Knee Due to a Multi-Sensitive Streptococcus pyogenes Strain Responsive to Clindamycin—A Case Report
by Giada Maria Di Pietro, Irene Maria Borzani, Sebastiano Aleo, Samantha Bosis, Paola Marchisio and Claudia Tagliabue
Children 2021, 8(3), 189; https://0-doi-org.brum.beds.ac.uk/10.3390/children8030189 - 03 Mar 2021
Cited by 3 | Viewed by 4011
Abstract
Septic arthritis is an inflammatory process usually generated by a bacterial infection. The knee is one of the most frequently involved joints. The etiology varies depending on age, and hematogenous spread remains the primary cause in children. Herein, we report a case of [...] Read more.
Septic arthritis is an inflammatory process usually generated by a bacterial infection. The knee is one of the most frequently involved joints. The etiology varies depending on age, and hematogenous spread remains the primary cause in children. Herein, we report a case of a previously healthy three-year-old female who was referred to our institution for acute swelling of her right knee. After a clinical and radiological diagnosis of septic arthritis, an empirical treatment with a combination of cefotaxime and clindamycin was initiated. The isolation of a multi-sensitive Streptococcus pyogenes strain from the joint’s effusion prompted the discontinuation of clindamycin and the usage of cefotaxime alone. One week later, an ultrasound was executed due to worsening in the patient’s clinical conditions, and an organized corpuscular intra-articular effusion with diffuse synovial thickening was revealed. Cefotaxime was therefore replaced with clindamycin, which improved the symptoms. Despite the antibiotic sensitivity test having revealed a microorganism with sensitivity to both cephalosporin and clindamycin, clinical resistance to cefotaxime was encountered and a shift in the antimicrobial treatment was necessary to ensure a full recovery. This case study confirms that an antibiotic regimen based solely on a susceptibility test may be ineffective for such cases. Full article
(This article belongs to the Special Issue Septic Arthritis and Related Conditions)
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