AB1210 SEPTIC ARTHRITIS IN HEMODIALYSIS PATIENTS

Abstract

<h3>Background</h3> The frequency of musculoskeletal disorders in hemodialysis patients varies around 60% as the duration of their dialysis increases. Their physiopathology is complex and multifactorial. Septic arthritis represents 30% of these arthropathies. <h3>Objectives</h3> analyze the clinical, biological and radiological characteristics of septic arthritis in hemodialysis patients and to assess the results of the proposed treatment. proposed treatment. <h3>Methods</h3> This is a retrospective study of 22 observations of septic arthritis in hemodialysis patients identified in our department over a 5-year period (2015-2022). <h3>Results</h3> The mean age was 43 years [22-60]. The sex ratio is equal to 1. The average duration of hemodialysis was 11.5 years [3 months-28 years]. Joint involvement was acute in 17 cases, with a mean duration of 4 days [1 day-1 week]. It was mono-articular, affecting the knee in18 cases and the elbow in 2 case, oligoarticular in 18 cases, and poly-articular in 2 case. Sacroiliitis was noted in 1 case. Biology: sedimentation rate, CRP and procalcitonin were increased in all patients. On standard radiography: obvious signs of arthritis were observed in 17 cases. Ultrasound showed joint effusion in 18 cases. Lumbar and sacral CT scans were performed in 1 case each and revealed multifocal destructive sacral arthropathy in 1 case and were consistent with unilateral sacral ilitis. Scintigraphy was requested twice. Joint biopsy was performed in 15 cases. Surgical treatment was required in 17 case.s. arthrotomy with joint lavage and biopsy of the synovium followed by an adapted antibiotic therapy according to the antibiogranmJe during 3 weeks by IV route relayed by an oral intake during 3 weeks while the antibiotic treatment alone after biopsy was practiced in 3 patients for two cases of polyartlu-itis and one case of deep localization. <h3>Conclusion</h3> Arthropathies of hemodialysis patients can have several clinical aspects. They occur on average after 10 years of hemodialysis. <h3>References</h3> [1]Aitkens L, Winn M, Waller JL, Huber L, Baer SL, Mohammed A, Kheda M, Tran S, Siddiqui B, Padala S, Colombo RE, Bollag WB. Septic arthritis in the end-stage renal disease population. J Investig Med. 2022 Feb;70(2):383-390. [2]Matthew Winn, BS, Jennifer Waller, PhD, N. Stanley Nahman, Jr., MD, Lu Huber, MD, Stephanie Baer, MD, Mufaddal Kheda, MD, Rhonda Colombo, MD, Septic Arthritis in End-Stage Renal Disease, Open Forum Infectious Diseases, Volume 3, Issue suppl_1, December 2016, 1135, <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.