Pediatric septic shoulder arthritis. Is routine arthrotomy still necessary?

Pääkkönen, M.; Peltola, H.; Kallio, M.; Kallio, P.

Duodecim; Laaketieteellinen Aikakauskirja 127(7): 716-719


Arthrotomy is recommended as a routine treatment for childhood septic arthritis of the shoulder, although scientific evidence is lacking. Suggested alternatives are arthroscopic lavage, serial aspirations and a mere diagnostic aspiration. 9 patients with septic arthritis of the shoulder aged 3 months to 12 years underwent a diagnostic aspiration after which large dose antimicrobials were given qid (clindamycin or 1st generation cephalosporin). One child underwent arthrotomy, otherwise all patients recovered normally. There were no sequelae. Routine arthrotomy for all patients is of questionable value in the emergency treatment of septic shoulder arthritis in children.