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Ultrasonography Assessment of Septic Arthritis on Native Joint

Not Applicable
Completed
Conditions
Septic Arthritis
Interventions
Other: Ultrasonography assessment
Registration Number
NCT02018952
Lead Sponsor
Nantes University Hospital
Brief Summary

The aim of this trial is to study the interest of ultrasonography among patients with septic arthritis.

Currently, ultrasonography is useful for detecting small fluid effusions, for examining otherwise inaccessible joints, such as the hip and for helping the joint aspiration.

Accurate assessment of disease activity and joint damage in septic arthritis is important for monitoring treatment efficiency and for prediction of the outcome of the disease.

Nowadays, magnetic resonance imaging (MRI) provides better resolution than radiography or tomography for the detection of joint effusion and for differentiation between bone and soft tissue infectious. The sensibility is reported to be nearly 100% with a specificity of more than 75%.

However, MRI is expensive and not rapidly accessible.

Therefore, ultrasonography, a non invasive, painless, inexpensive, and non radiating exam can be used to assess the presence and extent of inflammation, destruction, and tissue response.

The objective is to describe, using ultrasonography, the abnormalities joint structure influenced the septic arthritis evolution and prognosis.

The investigators hope, at the end of this study, to evaluate ultrasonography interest in septic arthritis and to establish ultrasonography prognosis factors to predict treatment efficiency and functional outcome.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
28
Inclusion Criteria
  • Major patients hospitalized in Rheumatology, Infectiology, Orthopedy Department (hospital of Nantes, of La Roche sur Yon and of Saint-Nazaire) with a septic arthritis of shoulder, or elbow, or wrist , or hip, or knee, or ankle on native joint, with positive microbiologic culture joint fluid or positive hemoculture; the diagnosis was based on positive histology or imagery with an inflammatory joint fluid if the microbiologic cultures (hemoculture or joint effusion) were negative.
Exclusion Criteria
  • Presence of material on the targeted joint
  • Age < 18 years old
  • Patients under guardianship
  • Pregnancy

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Ultrasonography assessmentUltrasonography assessment-
Primary Outcome Measures
NameTimeMethod
Abnormalities joint structure influencing the septic arthritis evolution and prognosis15 months

Ultrasonography description of :

* synovium aspect : homogeneous, nodular

* maximum thickness synovium

* synovium doppler signal (grade 0, 1, 2, 3)

* presence and aspect of joint effusion : anechoic, hypo/hyperechoic, heterogeneous

* presence and aspect of bone erosions : single, minimal/deep, multiple, minimal/ deep

* presence of a synovium partitioning

* soft tissue aspect : cellulitis, myelitis

Secondary Outcome Measures
NameTimeMethod
Percentage of decreased range of motion relative to normal range of motion at 3 months15 months
The evolution of the abnormalities joint structure using ultrasonography15 months

To describe the evolution of ultrasonography parameters during the monitoring and to research a link between those ultrasonography parameters and prognostic indicators : ultrasonography parameters at day 0, Day 4, Day 15, and 3 months.

Return delay apyrexia15 months

To describe the evolution of ultrasonography parameters during the monitoring and to research a link between those ultrasonography parameters and prognostic indicators : Return delay apyrexia.

Measure of range of motion at 3 months15 months
Delay of surgical management15 months

To describe the evolution of ultrasonography parameters during the monitoring and to research a link between those ultrasonography parameters and prognostic indicators : Delay of surgical management.

Normalization of C Reactive Protein levels15 months

To describe the evolution of ultrasonography parameters during the monitoring and to research a link between those ultrasonography parameters and prognostic indicators : Normalization of C Reactive Protein levels.

Pain at rest measured by scale at 3 months15 months
Pain during activity measured by scale at 3 months15 months
Functional outcome score Short Form (SF) 36 at 3 months15 months

Trial Locations

Locations (3)

CH de Nantes

🇫🇷

Nantes, France

CH Saint-Nazaire

🇫🇷

Saint-Nazaire, France

CH La Roche-sur-Yon

🇫🇷

La Roche-sur-Yon, France

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