Septic Arthritis
Conditions
Keywords
Septic arthritis, Ultrasonography, Prognosis parameters
Brief summary
The aim of this trial is to study the interest of ultrasonography among patients with septic arthritis. Currently, ultrasonography is useful for detecting small fluid effusions, for examining otherwise inaccessible joints, such as the hip and for helping the joint aspiration. Accurate assessment of disease activity and joint damage in septic arthritis is important for monitoring treatment efficiency and for prediction of the outcome of the disease. Nowadays, magnetic resonance imaging (MRI) provides better resolution than radiography or tomography for the detection of joint effusion and for differentiation between bone and soft tissue infectious. The sensibility is reported to be nearly 100% with a specificity of more than 75%. However, MRI is expensive and not rapidly accessible. Therefore, ultrasonography, a non invasive, painless, inexpensive, and non radiating exam can be used to assess the presence and extent of inflammation, destruction, and tissue response. The objective is to describe, using ultrasonography, the abnormalities joint structure influenced the septic arthritis evolution and prognosis. The investigators hope, at the end of this study, to evaluate ultrasonography interest in septic arthritis and to establish ultrasonography prognosis factors to predict treatment efficiency and functional outcome.
Interventions
All patients will be seen at day 0, day 4, day 15 and at 3 months. These visits are usually programmed. Only monitoring ultrasonography, a non invasive exam, and self-administered questionnaires will be made, additional to standard exams for all patients included (no control group). Day 0 : * Information of patient and no opposition getting * Clinical exam * Laboratory tests * Radiography of the targeted joint * Ultrasonography of the targeted joint and controlateral joint (about 20 minutes) Day 4 : * Clinical exam * Laboratory tests * Ultrasonography of the targeted joint and controlateral joint (about 20 minutes) Day15 : * Clinical exam * Laboratory tests * Ultrasonography of the targeted joint and controlateral joint (about 20 minutes) M3 : * Clinical exam * Laboratory tests * Radiography of the targeted joint * Ultrasonography of the targeted joint and controlateral joint (about 20 minutes) * Functional outcome
Sponsors
Nantes University Hospital
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Major patients hospitalized in Rheumatology, Infectiology, Orthopedy Department (hospital of Nantes, of La Roche sur Yon and of Saint-Nazaire) with a septic arthritis of shoulder, or elbow, or wrist , or hip, or knee, or ankle on native joint, with positive microbiologic culture joint fluid or positive hemoculture; the diagnosis was based on positive histology or imagery with an inflammatory joint fluid if the microbiologic cultures (hemoculture or joint effusion) were negative.
Exclusion criteria
* Presence of material on the targeted joint * Age \< 18 years old * Patients under guardianship * Pregnancy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Abnormalities joint structure influencing the septic arthritis evolution and prognosis | 15 months | Ultrasonography description of : * synovium aspect : homogeneous, nodular * maximum thickness synovium * synovium doppler signal (grade 0, 1, 2, 3) * presence and aspect of joint effusion : anechoic, hypo/hyperechoic, heterogeneous * presence and aspect of bone erosions : single, minimal/deep, multiple, minimal/ deep * presence of a synovium partitioning * soft tissue aspect : cellulitis, myelitis |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The evolution of the abnormalities joint structure using ultrasonography | 15 months | To describe the evolution of ultrasonography parameters during the monitoring and to research a link between those ultrasonography parameters and prognostic indicators : ultrasonography parameters at day 0, Day 4, Day 15, and 3 months. |
| Return delay apyrexia | 15 months | To describe the evolution of ultrasonography parameters during the monitoring and to research a link between those ultrasonography parameters and prognostic indicators : Return delay apyrexia. |
| Delay of surgical management | 15 months | To describe the evolution of ultrasonography parameters during the monitoring and to research a link between those ultrasonography parameters and prognostic indicators : Delay of surgical management. |
| Normalization of C Reactive Protein levels | 15 months | To describe the evolution of ultrasonography parameters during the monitoring and to research a link between those ultrasonography parameters and prognostic indicators : Normalization of C Reactive Protein levels. |
| Measure of range of motion at 3 months | 15 months | — |
| Percentage of decreased range of motion relative to normal range of motion at 3 months | 15 months | — |
| Pain at rest measured by scale at 3 months | 15 months | — |
| Pain during activity measured by scale at 3 months | 15 months | — |
| Functional outcome score Short Form (SF) 36 at 3 months | 15 months | — |
Countries
France
Contacts
PRINCIPAL_INVESTIGATORBenoît LE GOFF, Doctor
Nantes University Hospital
STUDY_CHAIRGrégoire CORMIER, Doctor
Centre Hospitalier Departemental Vendee
PRINCIPAL_INVESTIGATOROriane MEROT, Doctor
CH Saint-Nazaire
Outcome results
None listed