3. Septic arthritis Flashcards
How common is it?
Rare, increasing incidence
2-10 per 100,000
Who does it affect?
Increasing age
People with co-morbidities eg OA, DM, CHF, ESRD
What causes it?
Bacterial infection of synovial joint
Trauma causing haematogenous spread, post-op complication, previous infection
Staph aureus, pyogenic bacteria
What risk factors are there?
Having RA Weakened immune system Recent joint surgery Joint prostheses IVDU Chronic renal failure / DM
How does it present?
Severe joint pain (knee is most common)
Swelling / warmth around joint
General malaise and fever / rigors
What signs may the patient have on examination?
Pyrexia
Signs of inflammation
Reduced movement and pain on passive and active movement
Increased NEWS
What other conditions might present similarly?
RA Osteoarthritis flare Gout / pseudo gout Reactive arthritis Haemarthrosis Lyme disease
How would you investigate?
FBC, CRP
Joint aspiration and fluid analysis (culture, gram stain)
Xray
What treatments are there?
Fluid drainage
Empirical abx (IV initially)
Surgical irrigation and debridement
What complications are there?
Osteoarthritis
Osteomyelitis
