Introduction:
Native joint septic arthritis (NJSA) of the hand is a seldom studied disease, with data often extrapolated from studies involving large joints (1). Middlemore’s catchment has been shown to have a high average incidence of NJSA at 21/1000 Person years (1). To gain further understanding of the microbiology and surgical treatment of NJSA of the hands, a data set from McBride et al (2020) was combined with an updated data set from 2016-2020.
Methods:
A retrospective coding based study replicated methods used for McBride et al. (1). The time period was from 1 July 2016 to 31st June 2020. Those patients <16 years old and admitted for <24 hours were excluded.
Results:
The combined dataset had a total of 447 patients with NJSA of the hand Including, Metacarpophalangeal (MCP, N=160) and Hand inter phalangeal joints (Hand IP, N=202) and the wrist (N=85).
Of those admitted for hand NJSA 92% of IP, 89% MCP and 82% of wrist infection went on to have open washouts. The mean number of washouts for MCP joints was 1.2 and Hand IP 1.26.
Causative organisms were isolated in 85%, the most common was Staphylococcus aureus (wrist 42%, MCP 44% and hand IP 63%) and Streptococcus pyogenes (wrist 17%, MCP 17% and hand IP 19%). Other streptococci and Eikenella species were the next most common causative agents. Patients requiring 2 or more washouts for clearance showed similar microbiology with S. aureus and streptococci being most common.
Conclusion
This dataset gives a well-rounded view of NJSA admission for hands. The most common organisms isolated are S. aureus and S. pyogenes. This highlights a difference between microbiology of large and SJSA, showcasing the need for further research into the topic.