ABSTRACT
OBJECTIVE: The aim of this study was to compare the functional results of 2 different procedure types, medical or surgical used in treating native joint septic arthritis. METHODS: In this cohort study, we reviewed the clinical registries of patients admitted to a single third-level hospital with the diagnosis of septic arthritis during the period of January 1, 2008, to January 31, 2016. RESULTS: A total of 63 cases of septic arthritis were identified in which the initial approach for 49 patients was medical (arthrocentesis), whereas the initial approach for 14 patients was surgical (arthroscopy or arthrotomy). Of the 49 patients who received initial medical treatment (IMT), 15 patients (30%) later required surgical treatment because of poor progress. The median age of the patients was 60 (SD, 18) years. The group who received IMT were older than those who received initial surgical treatment (median, 64 years [interquartile range {IQR}, 54-76 years], vs. 48 years [IQR, 30-60 years]). There was a larger percentage of male patients in the surgical group (78% vs. 42% [p = 0.018]). Thirty percent of the medical group had been receiving corticosteroid treatment (p = 0.018). Results of complete recovery of joint functionality showed no significant differences after 1 year (68% with MT vs. 67% with ST, p = 0.91). Both groups had similar symptom duration until diagnosis, duration of antibiotic therapy (median, 30 days [IQR, 28-49 days], vs. 29.5 days [IQR, 27-49] days), and mortality rate (3 in the medical group). CONCLUSIONS: The results of the study show that initial surgical treatment in patients with native joint septic arthritis is not superior to IMT. However, half of the patients with shoulder and hip infections treated with IMT eventually required surgical intervention, suggesting that perhaps this should be the preferred initial approach in these cases.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Arthritis, Infectious/drug therapy , Arthritis, Infectious/surgery , Arthrocentesis , Arthroscopy , Adult , Aged , Female , Humans , Male , Middle Aged , Recovery of Function , Retrospective Studies , Spain , Treatment OutcomeABSTRACT
BACKGROUND: Sialodochitis fibrinosa is a rare disease which is characterized by recurring episodes of pain and swelling of the salivary glands due to the formation of mucofibrinous plugs. Analytic studies ascertain elevated levels of eosinophils and immunoglobulin E (IgE). Imaging studies such as magnetic resonance imaging (MRI) and sialography reveal dilation of the main salivary duct (duct ectasia). Treatment is initially supportive, consisting of compressive massages, and use of antihistamines and/or corticosteroids. MATERIAL AND METHODS: In the following, 3 cases of sialodochitis fibrinosa are presented which were diagnosed in a third level hospital during the period of 2008 and 2016, as well as a literature review of all cases reported to our knowledge. RESULTS: Of the 41 cases found, including the 3 of this article, 66% were women with an average age of 45 years old. However, 75% of reported cases were of Japanese heritage. Involvement of the parotid glands was more frequent than the submandibular glands. In more than half of all cases treatment with compressive massages, antihistamines and/or corticosteroids was effective. CONCLUSION: Clinicians should consider sialodochitis fibrinosa as a diagnostic possibility when presented with cases of recurring parotid and submandibular gland tumescence.
Subject(s)
Magnetic Resonance Imaging/methods , Submandibular Gland Diseases/diagnosis , Submandibular Gland/diagnostic imaging , Adult , Diagnosis, Differential , Female , Fibrosis/diagnosis , Humans , Middle Aged , Recurrence , SialographyABSTRACT
No disponible
Subject(s)
Humans , Glutens/adverse effects , Fatigue Syndrome, Chronic/diagnosis , Fibromyalgia/diagnosis , Food Hypersensitivity/diagnosis , Signs and Symptoms , DiseaseABSTRACT
No disponible
No disponible
Subject(s)
Risk Factors , Calcium, Dietary/therapeutic use , Hip Injuries/complications , Hip Injuries/diagnosis , Osteoporosis/complications , Densitometry/methods , Prospective Studies , Predictive Value of Tests , Indicators of Morbidity and MortalityABSTRACT
No disponible
