Clinical and Radiographic Outcomes and Treatment Algorithm for Septic Arthritis in Children

BACKGROUND

Septic arthritis (SA) in children is an acute inflammatory disease of the joints. If not treated promptly, it could become a surgical emergency. The incidence of the disease in children in Europe is approximately 2-7 per 100,000 children. The aim of this systematic review was to investigate which of these treatments-arthrocentesis, arthrotomy, and arthroscopy-provides better results in children and when to use them.

METHODS

Three independent authors conducted a systematic review of PubMed, ScienceDirect, and MEDLINE databases to assess studies with any level of evidence that reported the surgical outcome of SA. Two senior investigators evaluated and approved each stage's findings.

RESULTS

A total of 488 articles were found. After screening, we chose 24 articles that were suitable for full-text reading based on the inclusion and exclusion criteria. The results of our analysis showed that there are no numerically significant differences reported in the literature on clinical and radiographic outcomes by surgical technique.

CONCLUSIONS

We developed an algorithm that could be used if septic arthritis is suspected. Based on our results, the surgical technique to be used will depend on the operator who will perform it.

The Onset of Musculoskeletal Pain in the COVID-19 Era: A Survey of Physiotherapy Students in Sicily

Online teaching has resulted in university students adopting a sedentary lifestyle. Prolonged sitting and reduced physical activity due to pandemic restrictions have led to musculoskeletal pain in various body areas, significantly impacting students' quality of life. This study aims to investigate the effects of remote learning on Sicilian physiotherapy students during the COVID-19 pandemic, specifically focusing on the occurrence of musculoskeletal pain. An observational study was conducted using an online survey administered through Google Forms. The survey consisted of 26 multiple-choice questions and was distributed to students enrolled in physiotherapy programs at the universities of Catania, Messina, and Palermo. Participants were contacted via social channels or email, and data collection spanned 5 weeks. The collected data were analyzed using R software. A total of 128 questionnaires were collected. At the time of compilation, most respondents (n = 103/201, 51.2%) were enrolled in the third year of the course of study in physiotherapy at the universities of Catania, Messina, and Palermo. Their ages ranged between 22 and 25 years (43.3%), and most were female (n = 104/201, 51.7%). More than half of the students (51.6%) reported dedicating 15-22 h per week to distance learning for a duration of 6-12 months (50%). Regarding study location, most students preferred studying at a desk (82.8%), and slightly over half (57.8%) adopted a backrest while studying remotely. Analysis of the students' posture during study hours revealed common positions, including tilting the head forward by more than 20 degrees (47.8%), leaning the trunk forward by more than 20 degrees (71.9%), hunching both shoulders forward (57.0%), wrists positioned above the level of the elbows (46.1%), thighs pointing upwards (41.4%), and one or both feet in a downward or dorsiflexed position (69.5%). In conclusion the questionnaire responses indicate that the lifestyle of university students, influenced by online teaching, has deteriorated, leading to musculoskeletal pain, including myofascial pain. These results are primarily influenced by the adopted posture and the duration of time spent in these positions. Additionally, research is needed to identify the most effective therapeutic approaches for managing musculoskeletal pain.