Elbow septic arthritis in children: clinical presentation and management

Abstract

The elbow is a rare location for septic arthritis, and this fact may produce diagnostic errors. The purpose of this study is to determine the most typical clinical presentation and to evaluate the management and functional outcome of these patients. We present our experience with this entity. This is a retrospective study of seven cases between February 2004 and November 2007, five girls and two boys with a mean age of 2.8 years, ranging from 1.2 to 4.9 years. We explain our diagnosis criteria and management algorithm. Functional results were evaluated using the Mayo Elbow Performance Score. It is necessary to suspect septic arthritis in an elbow with persistent pain and functional limitation (24–48 h) and no earlier trauma. The most frequent infectious agent is Staphylococcus aureus. Using specific antibiotics until the disappearance of radiological changes we have obtained excellent clinical results according to the Mayo Elbow Performance Score.