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Point-of-Care Ultrasound and the Septic Prosthetic Hip Joint.
- Source :
-
The Journal of emergency medicine [J Emerg Med] 2019 Nov; Vol. 57 (5), pp. 701-704. Date of Electronic Publication: 2019 Oct 31. - Publication Year :
- 2019
-
Abstract
- Septic joints can have an insidious onset and are difficult to diagnosis. Diagnosis can be more complicated in the setting of a distant prosthetic joint. Plain films and inflammatory markers are not specific and magnetic resonance imaging (MRI) is not a timely test in the emergency department. Computed tomography (CT) scan is quick and useful to evaluate for bony changes or signs of inflammation, but lacks the details of MRI, and the prosthetic joint may cause significant artifact. Point-of-care ultrasound (POCUS) is often used in the pediatric population to evaluate for an effusion when there is a concern for a septic native hip joint and is finding a role in adult emergency medicine to evaluate for an effusion in painful native adult hip joints. Even so, ultrasound is not currently included in diagnostic algorithms for diagnosing prosthetic hip joint infections (PJIs). POCUS is, however, readily available in the emergency department. We present a case where POCUS aided in identifying a periprosthetic synovitis and changed the course of the patient's management from previous physical therapy to an investigation toward the final diagnosis of a septic prosthetic hip joint.<br /> (Copyright © 2019 Elsevier Inc. All rights reserved.)
- Subjects :
- Aged
Arthroplasty, Replacement, Hip methods
Emergency Service, Hospital organization & administration
Equipment Failure Analysis
Humans
Male
Osteoarthritis, Hip surgery
Point-of-Care Systems standards
Point-of-Care Systems trends
Staphylococcus aureus drug effects
Staphylococcus aureus pathogenicity
Ultrasonography standards
Arthroplasty, Replacement, Hip adverse effects
Hip Prosthesis adverse effects
Ultrasonography methods
Subjects
Details
- Language :
- English
- ISSN :
- 0736-4679
- Volume :
- 57
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- The Journal of emergency medicine
- Publication Type :
- Academic Journal
- Accession number :
- 31677979
- Full Text :
- https://doi.org/10.1016/j.jemermed.2019.08.004