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Case Reports
. 2022 May 24:29:e01513.
doi: 10.1016/j.idcr.2022.e01513. eCollection 2022.

Acute septic arthritis of the acromioclavicular joint caused by Staphylococcus aureus with marked soft tissue collection towards posterior medial aspect of the AC joint: A rare clinical presentation

Jija Thomas  1 , Makki Daud  2 , Simon Macmull  2
Affiliations
Case Reports

Acute septic arthritis of the acromioclavicular joint caused by Staphylococcus aureus with marked soft tissue collection towards posterior medial aspect of the AC joint: A rare clinical presentation

Jija Thomas et al. IDCases. .

Abstract

Primary septic arthritis of the Acromioclavicular joint is an unusual disorder and is seldom seen even in an immunocompromised person. We report a case of primary septic arthritis of the acromioclavicular (A-C) joint caused by Staphylococcus aureus. The patient was admitted with pain in the left shoulder, restricted movements and fever. Laboratory parameters showed elevated C-reactive protein, raised erythrocyte sedimentation rate and leukocytosis. Ultrasound revealed a 32 mm collection at the acromioclavicular joint. Patient underwent incision and drainage of abscess. Culture and sensitivity revealed moderate growth of Staphylococcus-aureus. Patient was started on appropriate intravenous antibiotics. Magnetic resonance imaging (MRI) done after 2 weeks revealed marked erosion in the lateral end of clavicle with soft tissue collection along the posteromedial aspect A-C joint. The patient had to undergo repeat drainage of the abscess along with the decompression of lateral end of clavicle. The patient was successfully treated with 8 weeks of appropriate antibiotics with complete resolution of infection.

Keywords: Acromioclavicular joint; Infection; Magnetic resonance imaging; Septic arthritis; Staphylococcus aureus.

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Figures

Fig. 1
Fig. 1
Photograph of the patient when he initially presented.
Fig. 2
Fig. 2
A plain radiograph of the shoulder showed joint space widening with acromioclavicular joint osteoarthritis.
Fig. 3
Fig. 3
Plain radiograph of the shoulder (Axial view) showing joint space widening and acromioclavicular joint osteoarthritis.
Fig. 4
Fig. 4
Ultrasonography showed 32 mm fluid collection over the left Acromioclavicular joint, with increased vascularity.
Fig. 5
Fig. 5
Photograph of the patient after two weeks.
Fig. 6
Fig. 6
Photograph of the patient after two weeks.
Fig. 7
Fig. 7
Precontrast and post contrast MRI images of patient performed at 2 weeks.
Fig. 8
Fig. 8
Precontrast and post contrast MRI images of patient performed at 2 weeks.
Fig. 9
Fig. 9
Precontrast and post contrast MRI images of patient performed at 2 weeks.
Fig. 10
Fig. 10
Precontrast and post contrast MRI images of patient performed at 2 weeks.
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