Recurrent arthritis as presenting symptom of osteomyelitis

We present a patient who had one episode of prepatellar bursitis and subsequently several episodes of arthritis of his right knee. Cultures of several punctures of his knee remained sterile, but the patient had been taking oral antibiotics on each of these occasions against our medical advice. Ultim...

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Bibliographic Details
Published in:	Clinical rheumatology Vol. 22; no. 3; pp. 237 - 239
Main Authors:	Haine, S E, Reenaers, V J, Van Offel, J F, Gielen, J L, D'Anvers, J P, Stevens, W J, De Clerck, L S
Format:	Journal Article
Language:	English
Published:	Germany Springer Nature B.V 01-09-2003
Subjects:	Anti-Bacterial Agents Arthritis, Infectious - diagnosis Arthritis, Infectious - drug therapy Diagnosis, Differential Drug Therapy, Combination - administration & dosage Follow-Up Studies Humans Knee Knee Joint Magnetic Resonance Imaging Male Middle Aged Osteomyelitis - diagnosis Osteomyelitis - drug therapy Recurrence Risk Assessment Staphylococcal Infections - diagnosis Staphylococcal Infections - drug therapy Staphylococcus aureus - drug effects Staphylococcus aureus - isolation & purification Surgery Tomography, X-Ray Computed
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Summary:	We present a patient who had one episode of prepatellar bursitis and subsequently several episodes of arthritis of his right knee. Cultures of several punctures of his knee remained sterile, but the patient had been taking oral antibiotics on each of these occasions against our medical advice. Ultimately a diagnostic puncture revealed growth of Staphylococcus aureus. An X-ray demonstrated an osteolytic lesion of the patella, but no defect in the articular surface of the patella could be visualised. MRI demonstrated a communication between the osteomyelitic focus through the medial retinaculum to the bursa suprapatellaris and the knee joint. Osteomyelitis of the patella is mainly a disease of childhood. This case is, to our knowledge, the first report on the association between bursitis, osteomyelitis of the patella and recurrent septic arthritis of the knee in an adult. The literature is reviewed and discussed briefly.
Bibliography:	ObjectType-Case Study-2 SourceType-Scholarly Journals-1 ObjectType-Feature-4 content type line 23 ObjectType-Report-1 ObjectType-Article-3
ISSN:	0770-3198 1434-9949
DOI:	10.1007/s10067-003-0702-9