Pioarthritis in a child's elbow: case report

Abstract

Background: Pyogenic arthritis, or septic arthritis, is an acute joint infection characterized by the presence of pus in the synovial cavity, most commonly caused by Staphylococcus aureus. It is frequent in children under five years of age, primarily affecting the knee and hip, with elbow involvement being rare. The infection may occur via hematogenous spread, trauma, or local infection, leading to rapid cartilage degradation. Diagnosis is based on clinical and laboratory findings and synovial fluid analysis. Treatment includes intravenous antibiotic therapy and early joint drainage to prevent permanent functional sequelae.

Aim: To report a unique case of pediatric pyogenic arthritis treated in our service.

Methods: This case report describes a pediatric patient treated at the São Francisco University Hospital (HUSF) in Bragança Paulista, SP, Brazil, with informed consent obtained from legal guardians through a Free and Informed Consent Form. All data were collected from the archived medical records, with no additional procedures performed. The project was submitted to the HUSF Research Ethics Committee and follows the guidelines of Resolution 466/2012 of the Brazilian National Health Council, which regulates research involving human subjects.

Conclusion: Although more common in joints such as the knee and hip, pyogenic arthritis can affect the elbow in a severe and insidious manner, as demonstrated in this case. The patient initially presented only mild pain but progressed to fever, functional limitation, osteomyelitis, and insufficiency fracture, requiring multiple surgical interventions and prolonged antibiotic therapy for ten months. This case highlights the importance of early diagnosis, microbiological investigation, and continuous follow-up to prevent complications and ensure proper functional recovery.