A Case of Septic Arthritis of the Shoulder Joint That Developed after Suprascapular Nerve Block

• 作者: Hiroshi Takahashi Katsunori Fukutake Kosei Ishigaki Masayuki Sekiguchi Ryoichi Fukano Taihei Go Toshiyuki Tsutsui Yasuaki Iida
• 来源期刊: 矫形学期刊(英文)
• 学科: 工学
• 关键词: SEPTIC ARTHRITIS of the SHOULDER Joint Suprascapular Nerve Block ROTATOR CUFF TEAR
• 年，卷（期）: 2020,（2）
• 页码范围: 25-32
• 页数: 8页
• 分类号: TE3

摘要

Septic arthritis of the shoulder is uncommon in the immunocompetent patient with no previous risk factors for joint infection. We treated an immunocompetent patient who developed septic arthritis of the shoulder after suprascapular nerve block for pain due to rotator cuff tear. An 80-year-old man with no underlying disease visited a nearby orthopedics clinic with complaint of left shoulder joint pain. Left suprascapular nerve block was performed, but the pain gradually aggravated. On the day after the block, he had a fever of 39°C and came to our department. On examination, enlargement and tenderness were present at the injection site. Cellulitis at the site was suspected. He was admitted and administration of a cephem anti-biotic was started. Pain subsequently decreased. Magnetic resonance imaging (MRI) performed 4 days after hospitalization showed massive effusion close to the injection site. The effusion spread into the joint cavity through the tear site of the supraspinatus. Septic arthritis of the shoulder was strongly suspected, open irrigation and debridement were performed 11 days after hospitalization. After surgery, pain immediately improved. In our case the extra-articular infection caused by suprascapular nerve block considered to spread into the shoulder joint cavity through the site of rotator cuff tear, although there have been no reports of such cases. This case suggests the possibility that patients with rotator cuff tear may easily develop septic arthritis because extra-articular infection may spread into the joint cavity through the site of tear.