Cervical facet joint septic arthritis: a case report

James M Stecher; Georges Y El-Khoury; Patrick W Hitchon

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Cervical facet joint septic arthritis: a case report

Journal article

Open access

Peer reviewed

Cervical facet joint septic arthritis: a case report

James M Stecher, Georges Y El-Khoury and Patrick W Hitchon

The Iowa orthopaedic journal, Vol.30, pp.182-187

2010

PMCID: PMC2958294

PMID: 21045995

Appears in Diamond Open Access

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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2958294View

Published (Version of record) Open Access

Abstract

Facet joint septic arthritis is a rare but severe infection with the possibility of significant morbidity resulting from local or systemic spread of the infection. Pain is the most common complaint on presentation followed by fever, then neurologic impairment. While the lumbar spine is involved in the vast majority of cases presented in the literature, the case presented here occurred in the cervical spine. The patient presented with a three week history of neck and left shoulder pain and was diagnosed by MRI when his pain did not respond to analgesics and muscle relaxants. The only predisposing factor was a history of diabetes mellitus and the infection most likely resulted from hematogenous spread. MRI is highly sensitive in diagnosing septic arthritis and it is the preferred modality for demonstrating the extent of infection and secondary complications including epidural and paraspinal abscesses as seen in this case. Without familiarity with this entity's predisposing factors, clinical symptoms and appropriate lab/imaging work up, many patients experience a delay in diagnosis. Treatment involves long term parenteral antibiotics or percutaneous drainage. Surgical debridement is reserved for cases with severe neurologic impairment. The incidence of facet joint septic arthritis is increasing likely related to patient factors (increasing number of patients >50 yo, immunosuppressed patients, etc), advancement in imaging technology, availability of MRI, and heightened awareness of this rare infection which is the aim of this case presentation.

Anti-Bacterial Agents - therapeutic use

Arthritis, Infectious - complications

Arthritis, Infectious - drug therapy

Arthritis, Infectious - pathology

Cervical Vertebrae - diagnostic imaging

Cervical Vertebrae - microbiology

Cervical Vertebrae - pathology

Debridement

Drainage

Humans

Magnetic Resonance Imaging

Male

Middle Aged

Neck Pain - etiology

Shoulder Pain - etiology

Staphylococcal Infections - complications

Staphylococcal Infections - drug therapy

Staphylococcal Infections - pathology

Staphylococcus aureus - isolation & purification

Tomography, X-Ray Computed

Treatment Outcome

Details

Title: Subtitle: Cervical facet joint septic arthritis: a case report
Creators: James M Stecher - Department of Radiology, University of Iowa, USA
Georges Y El-Khoury
Patrick W Hitchon
Resource Type: Journal article
Publication Details: The Iowa orthopaedic journal, Vol.30, pp.182-187
Publisher: Dept. of Orthopaedics, The University of Iowa; United States
PMID: 21045995
PMCID: PMC2958294
ISSN: 1541-5457
eISSN: 1555-1377
Language: English
Date published: 2010
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Radiology; Neurosurgery
Record Identifier: 9984304038302771

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