Sudarshan Munigangaiah1, Theresa A O’Sullivan2, Brian Lenehan2
1 Department of Trauma & Orthopaedic Surgery, Galway University Hospital, Galway, Ireland
2 Department of Trauma & Orthopaedic Surgery, Midwestern Regional Hospital Limerick, Dooradoyle, Co Limerick, Ireland
Osteoarthritis of knee is one of the common problems in elderly population. Intraarticular corticosteroid injection is a conservative management modality in osteoarthritis of knee. Septic arthritis is an infective complication of intraarticular corticosteroid injection. Septic arthritis in rheumatoid arthritis patients have worse prognosis because of delay in diagnosis. A higher rate of infectious complications following intraarticular injection is expected in immunocompromised and rheumatoid patients. We would like to report an extremely rare case of simultaneous bilateral knee septic arthritis after bilateral knee intraarticular steroid injection in a rheumatoid arthritis patient. Patient was treated successfully with multiple bilateral knee arthroscopic washouts and long-term intravenous antibiotics. This case report emphasizes the increased risk of infection in rheumatoid arthritis patients and a risk benefit assessment on individual basis before carrying out intraarticular steroid injection. Patient should be aware of this increased risk of infection.
Keywords: Corticosteroid injection, intraarticular injection, knee arthritis, rheumatoid arthritis, septic arthritis