ACUTE SUPPURATIVE ARTHRITIS IN INFANCY AND CHILDHOOD

Abstract

1. A regime of treatment for acute suppurative arthritis in childhood has been proposed. This consists of: urgent arthrotomy of the affected joint, if possible within five days; skin closure without drainage; antibiotics; and immobilisation of the joint for six weeks. 2. Fifty hips have been treated by this regime: all are clinically and radiologically normal The failure to achieve these results with other forms of treatment is due to delay in diagnosis, inadequate drainage together with lack of immobilisation of tile affected joint, and inadequate treatmellt with antibiotics. 3. Early diagnosis determines the ultimate prognosis. It is suggested that in doubtful cases exploratory arthrotomy is indicated. Eleven hips were found to Ilave some other cause for the signs and symptoms, but the children have suffered no ill effects from the arthrotomy. 4. Diagnostic aspiration is an unsatisfactory method, especially ill the case of tile hip, and should be avoided. Incision is preferable. 5. Acute suppurative arthritis of infancy is a serious condition. Diagnosis is difficult and is often delayed, so that the affected joint may be destroyed. In this small series of nine, seven affected joints were destroyed.