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Una strana artrite settica dell’anca

Claudia Mandato1, Daniele De Brasi1, Francesco Esposito2, Simona Vetrella3, Paolo Siani1

1UOC Pediatria, Dipartimento di Pediatria Sistematica e Specialistica, 2UOC Radiologia Pediatrica, 3UOC Oncologia Pediatrica, AORN Santobono-Pausilipon, Napoli

Key words: Septic arthritis of hip, Diagnosis, Neuroblastoma

The paper reports the case of a 3-year-old girl presenting with septic arthritis of left hip with poor clinical response to treatments. The child had been treated for at least 3 weeks by hip joint drainage and antibiotic therapy based on synovial fluid culture (positive for Coagulase negative Staphylococcus). Seven days after discharge she was admitted to our paediatric division for relapse of hip pain. Biochemical investigation showed increase in inflammatory parameters and mild anemia. Roentgenogram of the hips and femora revealed a markedly altered left proximal femoral region with disruption of subcortical bone. Hip ultrasonography was compatible with diagnosis of septic arthritis of the hip. After few days of antibiotic treatment she revealed worsening of hip pain, right knee pain, and abdominal pain, poorly responsive to analgesic treatment. Eventually, abdominal US scan showed a mass in adrenal right region compatible with malignancy. It was diagnosed as neuroblastoma stage 4, n-myc unamplified.

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C. Mandato, D. De Brasi, F. Esposito, S. Vetrella, P. Siani Una strana artrite settica dell’anca. Medico e Bambino pagine elettroniche 2013;16(3) https://www.medicoebambino.com/?id=CCO1303_50.html

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