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Radiographic features in septic arthritis.

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998
Radiographic Features in
Septic Arthritis
To the Editor:
We found the radiographic features in septic arthritis described by Master et al. (1) extremely interesting.
We would however question the interpretation of
their Figures 4 and 5 . The position of the scapula in the
two radiographs is not comparable. Thus, although the
humeral head appears to have subluxed superiorly, its
relationship to the glenoid remains unchanged. This is
illustrated in our Figures 1 and 2 that show a normal
shoulder with slight alteration of patient’s position.
ISABELLAS. LIYANAGE,
MRCP, FRCR, DMRD
Consultant Radiologist
SUNIL
P. LIYANAGE,
MRCP, DCH
Consultant Rheumatologist
Canadian Red Cross Memorial Hospital
Taplow, England
REFERENCE
I . Master R, Weisman MH, ArmbusterTG,Slivka J, Resnick
D, Goergen TG: Septic arthritis of the glenohumeral joint.
Arthritis Rheum 201500-1506, 1977
Author’s Response
The Doctors Liyanage are correct in stressing
that the relative position of the humeral head t o the
acromium is influenced by the attitude of the shoulder
during radiography. We attempted in all instances to
obtain comparable radiographs in our patients with septic arthritis of the glenohumeral joint but in some cases,
because of patient discomfort, this was not possible.
Thus, Figures 4 and 5 in our article are exposed in
different positions. This certainly could account for an
apparent change in the position of the humeral head. I n
our experience, such change in patient position accounts
for slight modification (up to 5 mm) of the position of
the humeral head with respect to the inferior aspect of
the tip of the acromium (the tip of this structure is
Figures I and 2. These radiographs of the same normal shoulder demonstrate apparent subluxation due to change in position of patient. Nore rhat
relationship of humeral head to glenoid is unchanged.
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features, septic, radiographic, arthritis
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