Antalgic Gait as the Initial Presentation of Spontaneous Septic Arthritis of Pubic Symphysis: A Case Report

恥骨聯合之自發性敗血性關節炎以防痛步態為初期表現：病例報告

陳隆炯(Lung-Chiung Chen) ； 陳柏瑞(Po-Jui Chen) ； 林伯堅(Bo-Jian Lin) ； 陳彥霖(Yen-Lin Chen) ； 蔡適鴻(Shih-Hung Tsai) ； 廖敏策(Min-Tser Liao) ； 陳柏豪(Bo-Hau Chen)

《南臺灣醫學雜誌》 13卷2期 (2017/12) Pp. 86-90

https://doi.org/10.6726/MJST.201712_13(2).0005

摘要

Septic arthritis of the pubic symphysis is a rare form of arthritis. Children or adolescents having strenuous exercise are at risk of this form of spontaneous arthritis due to excessive repetitive movement making the site of microtrauma susceptible to seeding and colonisation by pathogens. It presents with fever and pubic pain irradiating to the groin and increasing when moving the hip, and this fact produces a antalgic gait. We report a 17 year-old male presenting with antalgic gait and fever after playing basketball game. Diagnosis of septic arthritis of the pubic symphysis is made by positive blood culture and magnetic resonance imaging showing signs of inflammation. The patient was treated with antibiotics with a good clinical response. Suspicion of septic arthritis of the pubic symphysis should be raised when a child or adolescent complains of a antalgic gait and has signs of infection after strenuous exercise.

關鍵字

antalgic gait ； septic arthritis ； pubic symphysis

並列摘要

恥骨聯合處的敗血性關節炎是種罕見的關節炎，劇烈運動後的孩童或青少年有罹患此種自發性關節炎的風險，因為運動時過多的重複動作造成了易感染致病菌的微創傷口。恥骨聯合處的敗血性關節炎常以發燒和恥骨部位的疼痛來表現，疼痛輻射至鼠蹊處並伴隨髖部運動而加劇，因此出現了防痛步態。我們報告了一位17歲的男性在參加籃球賽後出現了防痛步態及發燒，經由陽性的血液培養報告及具有發炎性徵兆的核磁共振檢查結果，診斷為恥骨聯合處的敗血性關節炎。病患接受抗生素治療後恢復良好。當有孩童或青少年在劇烈運動後出現防痛步態及感染的徵象，恥骨聯合處的敗血性關節炎是應該加以懷疑的病因。

並列關鍵字

防痛步態 ； 敗血性關節炎 ； 恥骨聯合