A Case of Septic Arthritis of the Shoulder Joint That Developed after Suprascapular Nerve Block

作     者：Taihei Go Toshiyuki Tsutsui Yasuaki Iida Katsunori Fukutake Ryoichi Fukano Kosei Ishigaki Masayuki Sekiguchi Hiroshi Takahashi 

作者机构：Department of Orthopedics Toho University Tokyo Japan Department of Orthopedics Sagamihara Chuo Hospital Kanagawa Japan Department of Orthopedics Omori Red Cross Hospital Tokyo Japan Department of Orthopedics Japan Community Health Care Organization Tokyo Kamata Medical Center Tokyo Japan 

出 版 物：《Open Journal of Orthopedics》 (矫形学期刊（英文）)

年 卷 期：2020年第10卷第2期

页      面：25-32页

学科分类：0820[工学-石油与天然气工程] 08[工学] 082002[工学-油气田开发工程] 

主　　题：Septic Arthritis of the Shoulder Joint Suprascapular Nerve Block Rotator Cuff Tear 

摘      要：Septic arthritis of the shoulder is uncommon in the immunocompetent patient with no previous risk factors for joint infection. We treated an immunocompetent patient who developed septic arthritis of the shoulder after suprascapular nerve block for pain due to rotator cuff tear. An 80-year-old man with no underlying disease visited a nearby orthopedics clinic with complaint of left shoulder joint pain. Left suprascapular nerve block was performed, but the pain gradually aggravated. On the day after the block, he had a fever of 39°C and came to our department. On examination, enlargement and tenderness were present at the injection site. Cellulitis at the site was suspected. He was admitted and administration of a cephem anti-biotic was started. Pain subsequently decreased. Magnetic resonance imaging (MRI) performed 4 days after hospitalization showed massive effusion close to the injection site. The effusion spread into the joint cavity through the tear site of the supraspinatus. Septic arthritis of the shoulder was strongly suspected, open irrigation and debridement were performed 11 days after hospitalization. After surgery, pain immediately improved. In our case the extra-articular infection caused by suprascapular nerve block considered to spread into the shoulder joint cavity through the site of rotator cuff tear, although there have been no reports of such cases. This case suggests the possibility that patients with rotator cuff tear may easily develop septic arthritis because extra-articular infection may spread into the joint cavity through the site of tear.