関節内注射後に発生した化膿性肩関節炎の2例

Septic Arthritis of the Shoulder Causing by Intra-Articular Injection. Reports of Two Cases

　症例1は70歳，女性．近医にてステロイドの肩関節内注射を3回施行後，肩の疼痛が増強し約4週間後に当院を受診した．化膿性肩関節炎の診断で観血的洗浄，滑膜切除術を施行し，術後1年3カ月では日常生活に支障なく改善した．症例2は49歳，女性．症例1と同院にてステロイドの肩関節内注射を施行後，肩の疼痛が増強し，約6週間後に当院を受診した．同診断で観血的洗浄，滑膜切除術を施行し，術後1年3カ月では関節可動域制限を伴っているが，概ね臨床症状は改善した．本症例は同院同時期に不適切な消毒による肩関節内注射によって発症したと思われる．関節節内注射をする場合，十分な消毒を行う必要がある．

　We treated two patients who developed septic arthritis of the shoulder as a result of intra-articular injections.

　Patient 1 was a 70-year-old woman with a chief complaint of left shoulder pain. She began to experience pain in her left shoulder after receiving three steroid injections at the same hospital, and four weeks later she came to our hospital for consultation. We diagnosed septic arthritis of the shoulder and treated it by arthrotomy. Pseudomonas was isolated from the shoulder. Fifteen months postoperatively her shoulder joint motion had returned to its previous range. Patient 2 was a 49-year-old woman with a chief complaint of left shoulder pain. She developed shoulder pain after two steroid injections at the same hospital, and six weeks later came to our hospital for consultation. We made a diagnosis of septic arthritis and treated it by arthrotomy. Pseudomonas was isolated from the shoulder. Fifteen months later, she still has mild limitation of joint motion, but no pain. We think these cases of septic arthritis which developed after intra-articular injections at the same hospital at the same time were caused by inadequate disinfection. Intra-articular injections should be performed after proper disinfection.