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Bilateral Septic Hip Epiphyseal Detachment in Children: A Case Report and Review of the Literature

Volume 7 | Issue 2 | May-August 2021 | Page: 20-23 | Ferdinand Nyankoue Mebouinz, Serge Etoundi Bekoé, Rose Bengono, Bertine Manuela Ndjeunga, Cathy Bebey Engome, Fabrice Arroye Betou

Authors: Ferdinand Nyankoue Mebouinz [1], Serge Etoundi Bekoé [1], Rose Bengono [1], Bertine Manuela Ndjeunga [2], Cathy Bebey Engome [3], Fabrice Arroye Betou [4]

[1] Department of Orthopaedic Trauma Surgery, Aristide Le Dantec Hospital, Cheikh Anta Diop University, Dakar, Senegal.
[2] Obstetrics Gynecology Clinic, Aristide Le Dantec Hospital, Cheikh Anta Diop University, Dakar, Senegal.
[3] Albert Royer Children’s Hospital University teaching Hospital of Fann, Cheikh Anta Diop University, Dakar,Senegal.
[4] Department of Cardiovascular and Thoracic Surgery, University teaching Hospital of Fann, Cheikh Anta Diop University, Dakar, Senegal.

Address of Correspondence
Dr Ferdinand Nyankoue Mebouinz,
Estrada do Forte do Alto Duque, 1449-005, Lisbon.
E-mail: ferdinandmebouinz@gmail.com


Abstract

Background: Diagnosed and treated fairly early, children’s septic arthritis of the hip has few or no complications. Septic epiphyseal detachment of the hip in children is a rare complication due to delayed treatment. Unilateral forms have been reported, but bilateral involvement has never been described in the literature.
Case presentation: We report the case of an 8-year-old girl who presented with hip pain associated fever and diminished lower limb movements, approximately 4 months after the onset of symptoms. The diagnosis of bilateral septic epiphyseal detachment of the hips was made and computerized tomography (CT) scan revealed osteonecrosis of both femoral heads. The necrotic epiphyses required removal in order to control the infection.
Conclusion: This report highlights the importance of early diagnosis of septic arthritis of the hip in the neonatal period. Any delay in presentation, diagnosis or management can result in irrecoverable sequelae for the developing hip and seriously impact long-term function.
Keywords: Septic arthritis, Bilateral, Epiphysis detachment, Hip, Ablation.


References

1. Barthes X, Safar A, Seringe R. Treatment of septic arthritis in children. Arch Pediatr. 1 mai 1997;4(5):460‑3.
2. Badgley CE, Yglesias L, Perham WS, Snyder CH. STUDY OF THE END RESULTS IN 113 CASES OF SEPTIC HIPS. JBJS. Oct 1936; 18(4):1047.
3. Siffert RS. The Effect of Juxta-epiphyseal Pyogenic Infection on Epiphyseal Growth. Clin Orthop Relat Res. Oct 1957; 10:131.
4. Teklali Y, Ettayebi F, Benhammou M, El Alami ZF, El Madhi T, Gourinda H, et al.
Septic arthritis in infants and children about 554 cases. J Pediatrics and Childcare. 2002;15(3):137‑41. https://doi.org/10.1016/S0987-7983(02)83036-5
5. Coulibaly Y, Diakite AA, Keita M, Diakite I, Dembele M, Diallo G. Epidemiology and therapy of osteoarthritis in children. Mali Med. 2009; 24(3):7–10.
6. Aroojis AJ, Johari AN. Epiphyseal Separations After Neonatal Osteomyelitis and Septic Arthritis, Journal of Pediatric Orthopaedics. July 2000; 20(4):544.
7. Wyers MR, Samet JD, Mithal LB. Physeal separation in pediatric osteomyelitis. Pediatr Radiol. 2019;49:1229-33. https://doi.org/10.1007/s00247-019-04410-8.
8. Gajdobranski D, Petković L, Komarcević A, Tatić M, Marić D, Pajić M. [Septic arthritis in neonates and infants]. Med Pregl. June 2003; 56(5‑6):269‑75.
9. Mue DD, Salihu MN, Yongu WT, Ochoga M, Kortor JN, Elachi IC. Paediatric Septic Arthritis in a Nigerian Tertiary Hospital: A 5-Year Clinical Review. West Afr J Med. Aug 2018; 35(2):70‑4.
10. Atarraf K, Arroud M, Chater L, Afifi MA. Post-infectious femoral epiphysis detachment, about two cases. Pan Afr Med J. Aug 2014; 18:319. https://doi: 10.11604/pamj.2014.18.319.2242.
11. Schiavon R, Borgo A, Micaglio A. Septic physeal separation of proximal femur in a newborn. J Orthop Traumatol. Jun 2009; 10(2):105‑10.
12. Singh D, Krishna LG, Siddalingaswamy MK, Gupta V. Extra capsular extrusion of femoral capital epiphysis – an unusual presentation of sequelae of septic arthritis of hip. J Pediatr Orthop Part B. Nov 2011; 20(6):428‑31.
13. Goergens ED, McEvoy A, Watson M, Barrett IR. Acute osteomyelitis and septic arthritis in children. J Paediatr Child Health. 2005;41(1‑2):59‑62.https://doi.org/10.1111/j.1440-1754.2005.00538.x
14. RAMSEYER P, CAHUZAC JP. Acute osteo-articular infection of limbs in children. Rev Prat. 2001; 9:337‑45.
15. Rasigade J-P, Trouillet-Assant S, Laurent F. Staphylococcal bone and joint infections.Rev Francoph Lab. 2016;2016(480):33‑40. http://doi.org/10.1016/S1773-035X(16)30085-5
16. Sferopoulos NK, Papavasiliou VA. [Proximal epiphyseal separation of the femur in the newborn: early ultrasonic diagnosis]. Revue de Chirurgie Orthopedique et Reparatrice de L’appareil Moteur. 1994 ;80(4):338-341.
17. Laine JC, Denning JR, Riccio AI, Jo C, Joglar JM, Wimberly RL. The use of ultrasound in the management of septic arthritis of the hip. J Pediatr Orthop Part B. 2015;24(2):95‑8.
18. Le Saux N. Diagnosis and management of acute osteoarticular infections in children. Paediatr Child Health. 18 jul 2018;23(5):344‑52.
19. Akakpo-Numado GK, Gnassingbe K, Songne B, Amadou A, Tekou H. [Hip septic arthritis in young children with sickle-cell disease]. Revue de Chirurgie Orthopedique et Reparatrice de L’appareil Moteur. Feb 2008; 94(1):58‑63. http://doi.org/10.1016/j.rco.2007.09.004
20. Fernandez FF, Langendörfer M, Wirth T, Eberhardt O. Treatment of septic arthritis of the hip in children and adolescents. Orthopeadic Trauma Surgery. Dec 2013; 151 (6):596‑602.
21. Seivert V, Milin L, Coudane H, Delagoutte J-P, Martrille L. Medical conditions and arthroscopy Osteoarthritis, osteochondromatosis, synovitis septic and rheumatologic arthritis. In: Hulet C, Flurin P-H, editors. Arthroscopic Technics of Upper Limb. Paris: Elsevier Masson; 2013 p. 153‑63.
22. Daffe M, Sarr L, Gueye AB, Dembele B, Diouf AB, Sane A, et al. Hip Septic Arthritis: A Rare Complication. Int J Paediatr Orthop. 2019; 5(1):25‑6.
23. Choi IH, Pizzutillo PD, Bowen JR, Dragann R, Malhis T. Sequelae and reconstruction after septic arthritis of the hip in infants. JBJS. 1990; 72(8):1150‑65.
24. Hunka L, Said SE, MacKenzie DA, Rogala EJ, Cruess RL. Classification and surgical management of the severe sequelae of septic hips in children. Clin Orthop Relat Res. 1982;171:30‑6.
25. Choi IH, Shin YW, Chung CY, Cho T-J, Yoo WJ, Lee DY. Surgical treatment of the severe sequelae of infantile septic arthritis of the hip. Clin Orthop. 2005; (434):102‑9.


How to Cite this Article:  Mebouinz FN, Bekoé SE, Bengono R, Ndjeunga BM, Engome CB, Betou FA | Bilateral Septic Hip Epiphyseal Detachment in Children: A Case Report and Review of the Literature |
International Journal of Paediatric Orthopaedics | May-August 2021; 7(2): 20-23.

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