Evaluation of Children with Arthritis: 9 Years Retrospectif Study/ARTRITLI COCUK OLGULARIN DEGERLENDIRILMESI: 9 YILLIK RETROSPEKTIF CALISMA

• Published in: Güncel pediatri Vol. 18; no. 2; p. 140
• Main Authors: Yesil, Edanur, Celebi, Solmaz, Ozcan, Nur, Ozer, Arife, Turan, Cansu, Bulbul, Beyhan, Ermutlu, Cenk, Sarisozen, Bartu, Hacimustafaoglu, Mustafa
• Format: Journal Article
• Language: Turkish
• Published: Galenos Yayinevi Tic. Ltd 01.08.2020
• Subjects: Causes of; Diagnosis; Drug therapy; Juvenile arthritis; Pediatric research; Turkey
• ISSN: 1304-9054
• DOI: 10.4274/jcp.2020.0014

INTRODUCTION: The aim of this study was to evaluate the clinical and laboratory findings and treatment responses of patients with arthritis. MATERIALS and METHODS: The medical records of 111 children (0-18 years) were evaluated who were hospitalized with the diagnosis of arthritis between January 2010 and January 2019 retrospectively. The aim of this study was to evaluate the clinical and laboratory findings and to investigate the treatment and prognostic features of the patients. RESULTS: A total of 111 patients, 66% were male and the mean age was 91 [+ or -] 56 (median 83,1-215) months. The most of the patients (n=62,56%) were between 3-10 years of age. Septic arthritis was diagnosed in 60% (n=67) of the patients. This diagnosis was followed by reactive arthritis (10%), juvenile idiopathic arthritis (10%), toxic/transient synovitis (5%) and other arthritis. On admission, there were pain in 96%, joint swelling in 63%, redness in 21%, increased temperature of the joint in 41%, decreased range of motion in 64%, and inability to walk in 38% of the patients. The most frequently involved joints were knee (51%) and hip (35%). The possibility of septic arthritis was significantly higher in patients with high fever (p=0,0001). The response to ibuprofen was higher in non-septic arthritis (p=0,0001). Arthrocentesis was performed in 55% (n=61) of the cases and 34% (n=38) of the patients had underwent intra-articular debridement surgery. Staphylococcus aureus and Streptococcus pyogenes were the most common microorganisms growth in joint fluid culture. When septic arthritis and other arthritis cases were compared, the effusion amount, the amount of fluid taken by puncture were significantly higher and the level of CRP and leukocytes were higher in septic arthritis group (p=0,001;p=0,025;p=0,018;p=0,032,respectively). Osteomyelitis was observed in 19%(n=21) of the cases. CONCLUSIONS: In this study, the probability of septic arthritis was found to be statistically significant in patients with fever, leukocyte>12100/[mm.sup.3], CRP>3 mg/dl, and effusion measured 8.5 mm or more by ultrasonography. Also, ibuprofen response was higher in non-septic arthritis group. Key words: Arthritis, childhood, septic arthritis. GIRIS ve AMAC: Bu calismada, klinigimize septik artrit ontanisi ile basvuran olgularin klinik ve laboratuvar bulgularinin ve tedavi yanitlarinin degerlendirilmesi amaclandi. YONTEM ve GERECLER: Ocak 2010-Ocak 2019 tarihleri arasinda artrit ontanisiyla yatmis olan 111 cocuk (0-18 yas) hasta kayitlari retrospektif incelendi. Olgularin klinik, laboratuvar bulgularinin degerlendirilmesi, tedavi ve prognostik ozelliklerinin incelenmesi planlandi. BULGULAR: Calismaya alinan toplam 111 hastanin %66'si erkek olup ortalama yaslari 91 [+ or -] 56 (medyan 83,1-215 araligi) ay idi. Olgularin cogunlugunu (n=62,%56) 3-10 yas araligindaki hastalar olusturdu. Olgularin %60'ina (n=67) septik artrit tanisi konuldu. Bu taniyi reaktif artrit (%10), juvenil idiopatik artrit (%10), toksik/gecici sinovit (%5) ve diger artritler takip etti. Basvuruda olgularin %96'sinda agri, %63'unde eklem sisligi, %21'inde kizariklik, %41'inde eklemde isi artisi, %64'unde hareket kisitliligi, %38'inde yuruyememe yakinmasi vardi. Siklikla tutulan eklemler diz (%51) ve kalcaydi (%35). Ates yuksekligi olan olgularda septik artrit olasiligi yuksek saptandi (p=0,0001). Septik artrit disi artritlerde ibuprofene yanit daha fazlaydi (p=0,0001). Olgularin %55'ine (n=61) ponksiyon yapildi, %34'u (n=38) eklem ici debridman operasyonu gecirdi. Eklem sivi kulturunde en sik ureyen mikroorganizmalar Staphylococcus aureus ve Streptococcus pyogenes idi. Septik artrit ile septik artrit disi olgular karsilastirildiginda, ultrasonografi ile olculen efuzyon miktari, ponksiyonla alinan sivi miktari septik artrit grubunda istatistiksel olarak anlamli oranda daha fazla, CRP ve lokosit sayisi ise septik artrit grubunda daha yuksek bulundu (sirasiyla p=0,001;p=0,025;p=0,018;p=0,032). Olgularin %19'unda (n=21) osteomyelit saptanip hepsi septik artrit grubundaydi TARTISMA ve SONUC: Bu calismada atesi olan, lokosit sayisi >12100/[mm.sup.3], CRP>3 mg/dl uzerinde olan olgularda, ultrasonografi ile 8,5 mm ve uzerinde efuzyon olculen olgularda septik artrit olma olasiligi istatistiksel anlamli bulundu. Septik artrit disi artritlerde ibuprofen yaniti daha fazlaydi. Anahtar Kelimeler: Artrit, cocukluk donemi, septik artrit.