化脓性肩关节炎一例报告

A case of septic arthritis of the shoulder

化脓性关节炎主要发生在下肢的大关节,而肩关节发生率仅占5%~12%[1],在临床上样本量较少,其诊疗模式仍在探索中。我院经治1例,临床疗效满意,报道如下。临床资料患者,男,70岁。以右肩疼痛、活动受限2年,加重伴红肿1个月,于2022年5月20日入我院。患者于2年前无明显诱因出现右肩关节疼痛,活动稍受限,无发热、恶心、呕吐等症,在当地民间诊所间断行针刺、拔罐放血、关节腔穿刺注射等治疗,期间右肩部症状偶有反复,1个月前患者右肩部因针刺、拔罐后出现疼痛加重.

Objective To review the diagnosis and treatment of a case of suppurative shoulder arthritis.Methods Right shoulder arthrotomy was performed after admission.After operation,the joint cavity was continuously flushed with antibiotics through negative pressure drainage device and intravenous infusion of antibiotics to control the recurrence of infection.Synovial fluid bacterial culture was performed regularly and imaging and inflammatory indexes were reviewed.Results After 30 days of observation in hospital,the right shoulder MRI before discharge showed that the intra-articular effusion was signiflcantly reduced,the inflammatory index returned to normal,and the joint puncture fluid bacterial culture showed sterile growth.There was no sign of recurrence in imaging and laboratory examination 2 weeks after discharge.Conclusions Open shoulder joint incision,drainage,irrigation,and appropriate postoperative antibiotics to control infection can effectively control the symptoms of septic arthritis of the shoulder.