Orthopedics - Oleksa A.P. 2006

Joint Diseases
Infectious Arthritides of Known Etiology
Other Post-Infectious Arthritides

There are cases of Arthritis in children following scarlet fever or measles, which manifest at the end of the illness or in the post-convalescent period.

Scarlet fever-associated arthritis can develop in any joints of both the upper and lower extremities. These are typically serous, though purulent forms also occur.

Serous scarlet fever synovitis is classified as toxic, since the pathogen of scarlet fever is absent in the joint punctate, making the exudate sterile. Such types of arthritis must be differentiated from rheumatic conditions, as they share clinical similarities and can also involve cardiac lesions in scarlet fever. The Diagnosis is primarily based on the patient's medical history. Following Treatment, the child recovers without complications.

Purulent scarlet fever arthritis may develop during a severe septic course of scarlet fever and presents with a severe clinical profile characteristic of all purulent joint infections. Streptococci are occasionally detected and cultured from the purulent punctate. The purulent inflammatory process causes significant destruction of the articular Cartilage, leading to ankylosis of the affected joint.

The management of purulent scarlet fever arthritis requires intensive and comprehensive treatment. Mandatory measures include antibacterial and detoxification therapies, joint aspiration with continuous irrigation using antibacterial solutions, reliable immobilization of the limb in a functionally favorable position, and, if necessary, the administration of autovaccines.

Post-measles arthritis arises and develops similarly to scarlet fever-associated arthritis, occurring as rare, isolated cases. Serous and serous-purulent measles arthritis is managed with the same therapeutic approach used for scarlet fever arthritis.