Septic arthritis of ankle joint in the paediatric age group: a retrospective study


  • Nasiur Rehman Department of Trauma and Orthopaedics, The Royal Infirmary of Edinburgh, 51 Little France Crescent, Old Dalkeith Road, Edinburgh
  • Marcin Zgoda Department of Trauma and Orthopaedics, University Hospital Crosshouse, Kilmarnock
  • Mohamed K. Osman Department of Trauma and Orthopaedics, Menia University Hospital



Septic arthritis, Ankle, Infection, Paediatric age group, Children


Background: Septic arthritis in paediatric age group poses a significant clinical problem. Common sites are hip and knee joint. There are several orthopaedic literatures available on septic arthritis of the hip and knee joint, however, literature on epidemiology, causative organisms and outcome of septic arthritis of the ankle are very few.

Methods: We conducted a retrospective study at a tertiary hospital with an aim to evaluate the incidence, causative pathogen, outcome and to identify differences, if any, between clinical features and laboratory findings of these patients when compared to those with hip and knee joint infection.

Results: 47 children were diagnosed with septic arthritis, of which, 14 had septic arthritis of the ankle. Mean age was 5.2 years (8 months - 12 years). 13 children had undergone joint aspiration as a primary procedure. 50% (7) children had positive culture. Streptococcus pyogenes was the commonest causative organism in our cohort (29%) followed by Staphylococcus aureus. Mean follow-up was 36 months (16 - 56 months). 13 children (93%) had good clinical outcome. 1 child developed early arthritis.

Conclusions: Septic arthritis of the ankle is a serious condition. Even-though the joint is superficial, diagnosing it clinically can be difficult due to less pronounced symptoms. This can lead to delay in establishing the diagnosis and commencing treatment, hence, it is imperative to have a high index of suspicion. We found early joint aspiration followed by a course of antibiotics to be an effective regimen in management of this devastating condition.

Author Biographies

Nasiur Rehman, Department of Trauma and Orthopaedics, The Royal Infirmary of Edinburgh, 51 Little France Crescent, Old Dalkeith Road, Edinburgh

MRCEM, MRCSEd, MCh (Tr & Orth)

Specialty Registrar, Trauma & Orthopaedics

Royal Infirmary of Edinburgh

Marcin Zgoda, Department of Trauma and Orthopaedics, University Hospital Crosshouse, Kilmarnock


Currently: Consultant, Trauma & Orthopaedics

University Hospital of Crosshouse

Mohamed K. Osman, Department of Trauma and Orthopaedics, Menia University Hospital

MD, FRCS (Tr & Orth)

Currently : Consultant, Trauma & Orthopaedics

Royal Hospital for Children



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Original Research Articles