An unusual case of neonatal elbow septic arthritis mimicking a distal humerus physeal injury/elbow dislocation

Abstract

Neonatal septic arthritis is a rare entity and an important differential diagnosis of distal humeral epiphyseal separation (DHES). DHES is yet again an infrequent phenomenon seen in less than 3.9% of physeal injuries which often masquerades as elbow dislocation. We report on a 20-day old term neonate referred with a suspected diagnosis of elbow dislocation following trauma. Subsequent to evaluation in a tertiary care hospital this was found to be a rare case of septic arthritis of elbow in a neonate mimicking DHES. The diagnosis of septic arthritis in neonates is often delayed because the characteristic symptoms and signs seen in older children are absent or subtle. DHES is a rare injury, which to an untrained eye, may be misdiagnosed as an elbow dislocation. Septic arthritis and acute osteomyelitis are differential diagnoses of DHES, however, the history of incidental trauma hoodwinked us to provisionally diagnose it as the latter.