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Rheumatology Advance Access originally published online on May 31, 2005
Rheumatology 2005 44(9):1157-1160; doi:10.1093/rheumatology/keh691
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© The Author 2005. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org

Septic arthritis as a late complication of carcinoma of the breast

V. Chanet, M. Soubrier, J. M. Ristori, P. Verrelle1 and J. J. Dubost

Immunology and Rheumatology Department (B. SAUVEZIE) and 1 Radiotherapy Department Jean Perrin Center, 63000 Clermont-Ferrand, France.

Correspondence to: V. Chanet, Internal Medicine Department, Hôtel-Dieu, University Hospital of Clermont-Ferrand, 63000 Clermont-Ferrand, France. E-mail: vchanet{at}chu-clermontferrand.fr

Objectives. To see if a past history of radiation therapy is a risk factor for septic arthritis.

Methods. We retrospectively searched our records of 282 patients with septic arthritis and found 10 cases of septic arthritis post-radiotherapy, all in females. We analysed our group, correlating them with the literature. We also compared our patients with a group of septic arthritis patients without radiation therapy.

Results. Nine had had radiation therapy for carcinoma of the breast. The shoulder joint was involved in six and the sternoclavicular joint in three. The tenth patient had had brachytherapy and radiation for carcinoma of the cervix and presented with septic arthritis of the hip. The mean age of the patients was 69 yr (49–82 yr). The mean time elapsed since radiation was 16 yr (3–34 yr). Twenty-three cases of shoulder septic arthritis in patients without past radiation therapy were selected for comparison. The five patients with past radiation therapy had fever less often and a longer time lapse before diagnosis. They required longer antibiotherapy. However, this prevented neither bone destruction nor relapse.

Conclusions. In our study, a past history of radiation therapy was observed in 6/50 infections of the shoulder, 3/5 infections of the sternoclavicular joint, 6/23 cases of septic arthritis of the shoulder and all cases of septic arthritis of the sternoclavicular joint for females. Radiation therapy seems to be a risk factor for septic arthritis. Diagnosis would be aided by a greater awareness of the clinical and radiological features of this septic arthritis.

KEY WORDS: Radiotherapy, Septic arthritis, Breast carcinoma


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