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An 18 year clinical review of septic arthritis from tropical Australia

Published online by Cambridge University Press:  15 May 2009

D. S. Morgan
Affiliation:
Division of Medicine, Royal Darwin Hospital, Northern Territory
D. Fisher
Affiliation:
Division of Medicine, Royal Darwin Hospital, Northern Territory
A. Merianos
Affiliation:
Disease Control Centre and Menzies School of Health Research, Royal Darwin Hospital, Northern Territory
B. J. Currie*
Affiliation:
Division of Medicine, Royal Darwin Hospital, Northern Territory Disease Control Centre and Menzies School of Health Research, Royal Darwin Hospital, Northern Territory
*
* Correspondence and requests for reprints: Assoc. Prof. B. J. Currie, Menzies School of Health Research, P.O. Box 41096, Casuarina, NT 0811, Australia.
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A retrospective study of 191 cases of septic arthritis was undertaken at Royal Darwin Hospital in the tropical north of Australia. Incidence was 9·2 per 100000 overall and 29·1 per 100000 in Aboriginal Australians (RR 6·6; 95% CI 5·0–8·9). Males were affected more than females (RR 1·6; 95% CI 1·2–2·1). There was no previous joint disease or medical illness in 54%. The commonest joints involved were the knee (54%) and hip (13%). Significant age associations were infected hips in those under 15 years and infected knees in those over 45 years. Seventy-two percent of infections were haematogenous. Causative organisms included Staphylococcus aureus (37%), Streptococcus pyogenes (16%) and Neisseria gonorrhoeae (12%). Unusual infections included three melioidosis cases. Polyarthritis occurred in 17%, with N. gonorrhoeae (11/23) more likely to present as polyarthritis than other organisms (22/168) (OR 6·0; 95% CI 2·1–16·7). Univariate and multivariate analysis showed the hip to be at greater risk for S. aureus than other joints. Open arthrotomy was a more successful treatment procedure than arthroscopic washout or needle aspiration.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1996

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