Glenohumeral septic arthritis in intravenous drug users: 10-year retrospective analysis

Objectives: The objective of this study is to assess cases of septic arthritis of the glenohumeral joint and its association with intravenous drug use. Material and Methods: Retrospective data from the past 10 years were obtained from the University Hospital System in Appalachia. 53 shoulders in 50 patients fit the inclusion criteria for glenohumeral septic arthritis and are included in the study. Statistical analyses were carried out using statistical software R (version 3.6.3, R Foundation, Vienna, Austria). Comparisons were made between cases with intravenous drug use versus all other cases. Results: The mean age for intravenous drug users with glenohumeral septic arthritis is lower than non-users. Intravenous drug users with glenohumeral septic arthritis also had higher rates of sepsis, bacteremia, endocarditis, septic emboli, and involvement of other joints compared to non-users. Conclusion: A younger age, the involvement of other joints, and presence of other severe infections should prompt the radiologist to further probe into any intravenous drug use, which may not always be previously divulged. Conversely, having a known history of intravenous drug use should prompt the radiologist to be on the lookout for other joint infections, endocarditis, and septic emboli.