Acute septic Arthritis Flashcards
What is acute septic arthritis?
Septic arthritis is also known as infectious arthritis, and is usually caused by bacteria.
Typically causes severe pain, swelling, redness and heat in affected joints
What are 3 routes of infection of acute septic arthritis?
- Haematogenous
- Eruption of bone abscess
- Direct invasion
What are common causative organisms for acute septic arthritis?
- Staphylococus aureus
- Haemophilus influenzae
- Streptococcus pyogenes
- E. coli
What is the 3 steps of pathogenesis for acute septic arthritis?
- Acute synovitis with purulent joint effusion
- Articular cartilage attacked by bacterial toxin and cellular enzyme
- Complete destruction of articular cartilage
What is the prognosis for acute septic arthritis?
- Complete recovery
- Partial loss of the articular cartilage and subsequent OA
- Fibrous or bony ankylosis
How would a neonate present with septicaemia due to acute septic arthritis?
- Irrability
- Resistent to movement
How would a child/adult present with acute septic arthritis?
- Reluctant to move the joint
- Increased temperature and pulse
- Increase tenderness
What investigations would we carry out for suspected acute septic arthritis?
- FBC, WBC, ESR, CRP, blood cultures
- X ray
- ultrasound
- aspiration
What is the most common cause of acute septic arthritis in adults?
- Infected joint replacement
- Death can occur due to this but it is v rare (1%)
- Staph aureus still causative organism
DDx for acute septic arthritis?
- Acute osteomyelitis
- Trauma
- Irritable joint
- haemophilia
- Rheumatic fever
- Gout
Tx for acute septic arthritis?
- General supportive measures
- Antibiotics (3-4 wks)
- Surgical drainage and lavage - emergency
- Infected joint replacements
