Ital J Pediatr
September 2024
Orthopedic Pediatric Surgery Department, Lapeyronie Hospital, CHU Montpellier, Montpellier University Hospital, University of Montpellier, 191 avenue du Doyen Gaston Giraud, Montpellier Cedex 5, 34295, France.
Expert Rev Hematol
August 2024
Department of Hematology, La Paz University Hospital-IdiPaz, Madrid, Spain.
J Community Hosp Intern Med Perspect
March 2024
Faculty Internal Medicine United Health Services Hospitals, Binghamton NY, USA.
Gout can potentially be diagnosed clinically and treated, if classical symptoms are present. In some cases, gout and osteomyelitis can have similar presenting signs and symptoms and it may be difficult to differentiate just on clinical presentation, routine laboratory workup and imaging like radiography or ultrasound. Arthrocentesis can be crucial in such scenarios to differentiate the two entities as missed opportunity to treat infectious etiology can have detrimental outcomes.
View Article and Find Full Text PDFPediatr Emerg Care
January 2024
From the Departments of Pediatric Emergency Medicine.
Septic arthritis is one potential cause of pediatric joint effusion and pain that may lead to significant morbidity. We present a case where point-of-care ultrasound was used to identify and aspirate a joint effusion in a pediatric patient with septic arthritis of the ankle, facilitating timely diagnosis and care. We review the technique for arthrocentesis of the ankle and literature on point-of-care ultrasound in the diagnosis of pediatric septic arthritis.
View Article and Find Full Text PDFFoot Ankle Surg
October 2022
Schön Klinik München Harlaching - FIFA Medical Centre, 81547 Munich, Germany.
Background: There is little valid data available on managing infected total ankle arthroplasty (TAA).
Methods: A single-center, retrospective evaluation from 20 patients with PJI (periprosthetic joint infection) of the ankle compared the bacteria isolated by preoperative arthrocentesis and intraoperative cultures to the pathogens of knee PJI. Long-term failure rates of irrigation and debridement (I&D) and polyethylene exchange, revision arthroplasty, and arthrodesis were analyzed.
Rom J Morphol Embryol
January 2022
Department of Immunology, Department of Biostatistics, University of Medicine and Pharmacy of Craiova, Romania;
Septic arthritis (SA) is a less common joint pathology with potentially fatal outcome. It is considered a medical emergency, in which prompt diagnosis and differentiation of bacterial etiology is essential for appropriate management. The knee is the most prevalent site for SA (~50% of cases), followed by hip, shoulder, and elbow.
View Article and Find Full Text PDFCureus
November 2021
Physical Medicine and Rehabilitation, Centro Hospitalar de Leiria, Leiria, PRT.
Ankle tuberculosis is a relatively rare condition and may develop after hematogenous dissemination from the pulmonary origin, particularly in cases of immunosuppression. Both pregnancy and delivery are relatively immunosuppressive states, and immune modulations during these periods can contribute to the pathogenesis of disseminated tuberculosis. A 26-year-old mother presented with severe, continuous, and debilitating pain in the left ankle, lasting for three months after delivery and associated with fever.
View Article and Find Full Text PDFAcad Emerg Med
February 2022
Department of Emergency Medicine, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA.
Objectives: Arthrocentesis is commonly performed in the emergency department, but success rates vary based on location. Presently, there is a paucity of data assessing the utility of ultrasound-guided (USG) medium-sized joint arthrocentesis. The objective of this study was to compare the success of USG and landmark-guided (LMG) medium-sized joint arthrocentesis.
View Article and Find Full Text PDFJ Orthop Res
April 2022
Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri, USA.
Posttraumatic osteoarthritis (PTOA) significantly affects patients with pilon fractures even after adequate anatomical reduction, and treatment strategies targeting the biologic mediators of PTOA are needed. This study was designed to determine the effects of intra-articular injection of platelet-rich plasma (PRP) on synovial fluid (SF) biomarkers for patients undergoing open reduction and internal fixation (ORIF) of pilon fractures. Patients undergoing staged management of pilon fractures were enrolled in a prospective, double-blinded, randomized, and placebo-controlled clinical trial to determine the effects of a single intra-articular injection of leukocyte-reduced PRP on SF biomarkers.
View Article and Find Full Text PDFJ Emerg Med
May 2021
Department of Emergency Medicine, University of Virginia Health System, Charlottesville, Virginia.
Background: Joint arthrocentesis is a commonly performed procedure by the emergency physician (EP). Point of care ultrasound (POCUS) has demonstrated promise in identifying joint effusions and guiding arthrocentesis procedures. EP-performed talonavicular joint arthrocentesis has not been previously described in the literature.
View Article and Find Full Text PDFJ Investig Med High Impact Case Rep
August 2021
Kern Medical, Bakersfield, CA, USA.
Coccidioidomycosis a fungal infection endemic to southwestern United States. It is caused by inhalation of spores of . Sixty percent of infections are asymptomatic; the remaining 40% are primarily pulmonary disease.
View Article and Find Full Text PDFJ Community Hosp Intern Med Perspect
May 2020
Methodist Dallas Medical Center, Dallas, TX, USA.
A 48-year-old male presented to the emergency room for 2 weeks of joint pain and swelling of his four extremities. His symptoms started suddenly and were quite debilitating. His hands, fingers, knees, and ankles were so swollen and painful that he was unable to get out of bed and had to use crutches to ambulate.
View Article and Find Full Text PDFRMD Open
August 2020
Department of Nephrology and Rheumatology, Kyorin University School of Medicine, Shinkawa, Mitaka-shi, Tokyo, Japan.
Reactive arthritis (ReA) is typically preceded by sexually transmitted disease or gastrointestinal infection. An association has also been reported with bacterial and viral respiratory infections. Herein, we report the first case of ReA after the he severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.
View Article and Find Full Text PDFExpert Rev Hematol
September 2020
Department of Physical Medicine and Rehabilitation "La Paz" University Hospital-IdiPaz, Madrid, Spain.
Introduction: After the ankle and knee, the elbow is the most commonly impaired joint in patients with hemophilia.
Areas Covered: A Cochrane Library and PubMed (MEDLINE) search related to elbow problems in hemophilia was conducted. Early and continuous primary hematological prophylaxis (ideally starting in infancy) is essential, given that the juvenile elbow is highly prone to the musculoskeletal complications of hemophilia.
J Med Educ Curric Dev
November 2019
Department of Emergency Medicine, The University of Arizona, Tucson, AZ, USA.
Background: Arthrocentesis of the ankle and elbow and brachial plexus nerve blocks are infrequently performed procedures; however, clinicians in specialties such as emergency medicine are required to be proficient in these procedures in the event of emergent or urgent necessity.
Objectives: The objective of this study was to create, implement, and assess a fresh cadaver-based educational model to help resident physicians learn how to perform ultrasound-guided arthrocentesis of the ankle and elbow and ultrasound-guided regional nerve blocks.
Methods: This was a single-center cross-sectional study conducted at an academic medical center.
Blood Coagul Fibrinolysis
September 2019
Department of Orthopedic Surgery, La Paz University Hospital, Madrid, Spain.
: The role of the orthopedic surgeon is to use invasive and/or surgical methods to treat the musculoskeletal disorders suffered by persons with hemophilia, always within the context of a multidisciplinary team. Muscle hematomas must be diagnosed as early as possible and be subjected to continuous treatment until full resolution, as they are associated with the risk of severe complications (compartment syndromes and pseudotumors). Arthrocentesis (extraction of intra-articular blood) is recommended in cases of acute and profuse hemarthrosis.
View Article and Find Full Text PDFBlood Coagul Fibrinolysis
April 2019
Department of Hematology.
: Arthrocentesis of an acute hemarthrosis in hemophilia remains a controversial issue. The purpose of this study is to define the role that joint aspiration can play in the recovery from acute hemarthrosis in patients with hemophilia. The study sample included 33 hemophilic patients (55 joints) with acute elbow, knee, and ankle hemarthrosis as confirmed by ultrasonography.
View Article and Find Full Text PDFSouth Med J
April 2019
From the Department of Internal Medicine, Yale University School of Medicine, New Haven, and the Department of Medicine, Section of Infectious Diseases, Veterans Affairs Healthcare Systems of Connecticut, West Haven.
Objective: To determine whether there are differences in the outcomes of native joint septic arthritis (SA) in adults, based on medical versus surgical management.
Methods: A 10-year retrospective single-center study was conducted of patients admitted to a tertiary care hospital between January 1, 2006 and December 31, 2015 with a diagnosis of SA to compare outcomes based on the management approach taken: medical (bedside closed-needle joint aspiration) versus surgical (arthrotomy/arthroscopy). Evaluated outcomes included joint recovery, time to recovery, length of stay, disposition to home versus rehabilitation unit, recurrence of SA in the same joint, and mortality.
J Orthop Surg Res
January 2019
Centre for Joint Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400083, China.
Background: Due to atypical clinical presentation, wide use of antibiotics, and lack of specificity in diagnosis, diagnosis of tubercular (TB) infection in joints is increasingly difficult, and misdiagnosis is common. The use of arthroscopy for the diagnosis and treatment of early-stage ankle TB has rarely been reported. This case series intended to present the clinical outcomes of arthroscopic management for early-stage ankle TB.
View Article and Find Full Text PDFWest J Emerg Med
January 2019
Medical University of South Carolina College of Medicine, Department of Emergency Medicine, Charleston, South Carolina.
World J Emerg Med
January 2018
Department of Emergency Medicine, The University of Arizona, Tucson, AZ, USA.
Background: To evaluate the utilization of point-of-care ultrasound (POCUS) for the assessment of emergency department (ED) patients with musculoskeletal symptoms and the impact of musculoskeletal POCUS on medical decision-making and patient management in the ED.
Methods: This was a retrospective review of ED patients presenting with musculoskeletal symptoms who received a POCUS over a 3.5-year period.
Beijing Da Xue Xue Bao Yi Xue Ban
December 2017
Department of Rheumatology and Clinical Immunology, Peking University First Hospital, Beijing 100034, China.
Objective: To evaluate the ability of 2015 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) classification criteria to diagnose gout compared with the widely used 1977 American Rheumatism Association (ARA) criteria and other criteria in clinical practice in Chinese patients, and to compare the sensitivity and specificity of different classification criteria for gout in early and established diseases.
Methods: The patients who had ankle arthritis and visited the Department of Rheumatology and Clinical Immunology, Peking University First Hospital between February 2012 and February 2016 were screened. The patients who had been already diagnosed with gout or pyrophosphate deposition disease through arthrocentesis or tissue aspiration and those who had been diagnosed with rheumatoid arthritis, spondyloarthritis, and osteoarthritis were excluded.
Am J Emerg Med
February 2017
Department of Emergency Medicine, Keck School of Medicine of USC, LAC+USC Medical Center, 1200 N. State Street, Room 1011, Los Angeles, CA 90033, United States.
Purpose: The objectives of this study were to evaluate emergency medicine resident-performed ultrasound for diagnosis of effusions, compare the success of a landmark-guided (LM) approach with an ultrasound-guided (US) technique for hip, ankle and wrist arthrocentesis, and compare change in provider confidence with LM and US arthrocentesis.
Methods: After a brief video on LM and US arthrocentesis, residents were asked to identify artificially created effusions in the hip, ankle and wrist in a cadaver model and to perform US and LM arthrocentesis of the effusions. Outcomes included success of joint aspiration, time to aspiration, and number of attempts.
Semin Musculoskelet Radiol
February 2016
Department of Diagnostic and Interventional Radiology, Eberhard Karls-University Tübingen, Tübingen, Germany.
Gout is a true crystal deposition arthropathy caused by the precipitation of monosodium urate into joints and periarticular soft tissues. It is the most common inflammatory arthropathy in men and women of older age with a male-to-female ratio of 3 to 8:1. The disease may progress from asymptomatic hyperuricemia through symptomatic acute gout attacks with asymptomatic periods into chronic symptomatic tophaceous gout.
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