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Charlotte Watson, Valmiki Sharma
Bedfordshire Hospitals NHS, UK
Posters & Accepted Abstracts: Dentist Case Rep
Background: Post-traumatic septic arthritis is a rare and severe complication. This is most common in young, healthy males and most commonly affects the large joints of the lower limb. The most common pathogen responsible for septic arthritis is Staphylococcus aureus. Case: A 4-year-old male attended Luton and Dunstable A&E following a fall at home, resulting in a full-thickness laceration of the left eyebrow. This was sutured under local anaesthetic and the patient was sent home with chloramphenicol ointment. He then reattended 2 days later after developing swelling of the left eye and reporting inability to weight-bear on the right leg. Medically, he was generally fit and well. Extraoral examination showed left periorbital cellulitis with mild drainage from the laceration. The right leg and hip were painful on palpation. Bloods showed a raised white cell count of 29.7 and a CRP of 69.3. CT showed a pre-septal collection of the left eye and a subsequent MRI showed a collection in the right hip joint suggestive of septic arthritis. Management included wash-out of the right hip collection by orthopaedics and wash-out of the left eyebrow laceration under general anaesthetic. Swab taken from the eyebrow laceration showed Streptococcus A species. Osteomyelitis developed within the right hip, secondary to the initial septic arthritis. A PICC line was placed and the patient received 6 weeks of IV antibiotics. Conclusion: This case raises awareness of this complication rarely seen in maxillofacial trauma. It reinforces the importance of choosing the best modality of treatment of lacerations in children and ensuring thorough irrigation of traumatic lacerations. Recent Publications 1. Di Benedetto C, Hoffmeyer P, Lew D, Uçkay I. Post-traumatic septic arthritis. European Musculoskeletal Review. 2012 Feb; 2. Pääkkönen M. Septic arthritis in children: Diagnosis and treatment. Pediatric Health, Medicine and Therapeutics. 2017; Volume 8:65–8. doi:10.2147/phmt.s115429 3. Dodwell ER. Osteomyelitis and septic arthritis in children. Current Opinion in Pediatrics. 2013;25(1):58–63. doi:10.1097/ mop.0b013e32835c2b42
Charlotte Watson graduated from King’s College London Dental Institute in 2020. Since then, she has distinguished herself during one year of general dental practice and two subsequent years of training in a hospital. Her first year in the hospital covered Oral Surgery, Oral Medicine and Restorative at Guy’s Hospital in London. Currently, she is training at a busy Maxillofacial Surgery Unit at Luton and Dunstable, encountering a broad range of clinical scenarios. Although having a wide variety of clinical experience, she has a particular interest in Oral Surgery and is looking forward to developing this further.
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