Infections
of the upper limb
Osteomyelitis
Osteomyelitis of the upper limb is very uncommon in adults, unless there
are specific predisposing factors such as penetrating wounds. As with other
sites, staphylococci and streptococci are commonly implicated, although in the
immunocompromised patient other organisms may be encountered. The treatment of
osteomyelitis of the upper limb does not differ from other sites.
In
children, osteomyelitis of the proximal humeral metaphysis can occur but this is
much less common than osteomyelitis of the proximal femur or around the knee.
Septic
arthritis
In both adults and children, septic arthritis of the shoulder or elbow
is uncommon. Arthroscopy is preferred to formal
The shoulder and elbow are relatively uncommon sites for tuberculosis
(TB) and treatment is along conventional lines. Secondary degeneration can occur
and may be difficult to manage. A previously infected joint is one of the few
indications for shoulder arthrodesis but the elbow presents a dilemma.
Arthrodesis of the elbow is not a good procedure and there is little information
on the outcome of other methods of treatment after previous TB.