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SUPPURATIVE ARTHRITIS OF INFANCY

Some Observations upon Prognosis and Management



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Abstract

1. Attention is drawn to the powers of resistance of the growing ends of bones in suppurative pyogenic arthritis of the knee and hip in infancy.

2. It is emphasised that a translucent zone in the radiograph does not necessarily mean that this part of the bone, epiphysial cartilage or plate is destroyed.

3. Diagnostic criteria are described to confirm that cartilage or decalcified bone has survived the infection in the knee joint.

4. The prognosis for the knee joint is discussed.

5. The hip joint presents greater difficulties in diagnosis and greater issues are at stake. It is recommended therefore that the hip joint be manipulated or explored if the radiograph and the physical signs suggest that destruction of the joint has either caused dislocation or has so damaged it that dislocation is likely to occur in the future. In favourable cases stability may be restored to the hip. In the others a diagnosis of irreparable destruction is established and the surgeon is satisfied that an opportunity to help the patient has not been lost.

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