Infection

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A 77-year-old woman with right hip fluid collection, altered mental status

Orthopedics Today, May 2017
Eric M. Cohen, MD; Shaun P. Patel, MD; Valentin Antoci Jr., MD, PhD

A 77-year-old woman, who was found down at her home, was brought to the hospital by ambulance. Her mental status was altered. The patient’s medical history was significant for chronic obstructive pulmonary disease, oxygen at home (2L nasal cannula) and type 2 diabetes mellitus. She was underweight (BMI 17.2), and was taking opioids for chronic low back pain. Seven months earlier, the patient had fallen and reportedly had a right hip fracture at the time. She had been recovering well as a household ambulator who used a walker, but she continued to have baseline pain that was mostly associated with her back.

At admission, the patient’s labs were significant for a peripheral white blood cell count of 13.3 x 109/L with 85.7% neutrophils, lactic acid of 1.6 mmol/L (normal, 0.2 to 2.2 mmol/L), C-reactive protein of 61.7 mg/L (normal 0 mg/L to 10 mg/L), erythrocyte sedimentation rate of 51 mm/h (normal, 0 mm/h to 30 mm/h), hemoglobin of 12.3 g/dL and glucose of 241 mg/dL. A CT scan of the abdomen and pelvis with IV contrast showed mild thickening of the distal sigmoid colon, which possibly represents early colitis, as well as a previous right basicervical femoral neck fracture with bone resorption and an enhancing joint effusion (Figure 1).

Infection Watch

Role of microbiome in arthritic disease may be next frontier in medicine

Orthopedics Today, April 2017
Javad Parvizi, MD, FRCS; Noam Shohat, MD; Majd Tarabichi, MD
Since Nobel Laureates J. Robin Warren, AC, and Barry J. Marshall, AC, FRACP, FRS, FAA, DSc, implicated Helicobacter pylori as a causative agent in the pathogenesis of…
Meeting News

Multiple intra-articular steroid hip injections linked with increased risk of PJI after THA

April 10, 2017
SAN DIEGO — Patients who received multiple intra-articular steroid hip injections prior to total hip arthroplasty experienced a high risk of future periprosthetic…
From OT Europe

EFORT Open Reviews: A round-up of recently published articles

Orthopaedics Today Europe, April 2017
EFORT Open Reviews is the new open access journal from EFORT and The British Editorial Society of Bone & Joint Surgery. All articles are free to read online with no…
Feature Article

Extended-Spectrum Beta-Lactamase Infections in Orthopedic-Related Devices and Prosthetic Joints

Orthopedics, July/August 2016, Volume 39 Issue 4
Extended-spectrum beta-lactamase–producing Enterobacteriaceae have increasingly become a public health issue in a…
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CME

Bundled Payments in Orthopedic Surgery: February 2015

Bundled payments, the idea of paying a single price for a bundle of goods and services, is a financial concept familiar…
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Featured
Arthroscopy Association of North America Annual Meeting

Arthroscopy Association of North America Annual Meeting

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Meeting News

VIDEO: Iorio discusses modifiable risk factors, infection rates after TJA

April 3, 2017
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Review Article

Perioperative Management of Rheumatoid Medications in Orthopedic Surgery

Orthopedics
Online Advanced Release, May 22, 2017
Rheumatoid arthritis (RA) is a chronic, systemic autoimmune disorder known to cause progressive joint destruction. Over time, untreated RA can lead…

Orthopedics Today Grand Rounds

A 77-year-old woman with right hip fluid collection, altered mental status

Orthopedics Today, May 2017
Eric M. Cohen, MD; Shaun P. Patel, MD; Valentin Antoci Jr., MD, PhD
A 77-year-old woman, who was found down at her home, was brought to the hospital by ambulance. Her mental status was altered. The patient’s…

Infection Watch

Role of microbiome in arthritic disease may be next frontier in medicine

Orthopedics Today, April 2017
Javad Parvizi, MD, FRCS; Noam Shohat, MD; Majd Tarabichi, MD
Since Nobel Laureates J. Robin Warren, AC, and Barry J. Marshall, AC, FRACP, FRS, FAA, DSc, implicated Helicobacter pylori as a causative agent in…

Meeting News

Multiple intra-articular steroid hip injections linked with increased risk of PJI after THA

April 10, 2017
SAN DIEGO — Patients who received multiple intra-articular steroid hip injections prior to total hip arthroplasty experienced a high risk of…

From OT Europe

EFORT Open Reviews: A round-up of recently published articles

Orthopaedics Today Europe, April 2017
EFORT Open Reviews is the new open access journal from EFORT and The British Editorial Society of Bone & Joint Surgery. All articles are free to…

From OT Europe

EFORT FORA

Orthopaedics Today Europe, April 2017
Under the supervision of EFORT Fora Chair, Professor George Macheras, from Athens, Greece, EFORT is organizing 10 European Fora each year. Launched…

From OT Europe

Total hip and total knee replacement: What experts want to hear

Orthopaedics Today Europe, April 2017
During the past 4 years, the EFORT Advanced Course on Total Hip and Total Knee Replacement has achieved great acceptance among our congress…

Meeting NewsVideo

VIDEO: Iorio discusses modifiable risk factors, infection rates after TJA

April 3, 2017
SAN DIEGO — At the American Academy of Orthopaedic Surgeons Annual Meeting, Richard Iorio, MD, discussed modifiable risk factors for infection…

Tips & Techniques

Clinical Differences Between Monomicrobial and Polymicrobial Vertebral Osteomyelitis

Orthopedics, March/April 2017, Volume 40 Issue 2
Little literature exists examining differences in presentation and outcomes between monomicrobial and polymicrobial vertebral infections…

Meeting News

Patients with culture-negative PJIs required more operations to clear infection

March 17, 2017
SAN DIEGO — Patients who developed culture-negative infections following total joint arthroplasty required more operations to clear the…

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