Acute septic Arthritis Flashcards
1
Q
What is acute septic arthritis?
Symptoms?
A
Septic arthritis (infectious arthritis): bacterial joint infection, which rapidly destroys the joint
Symptoms:
- Monoarthritis: hot, red, swollen and painful joint (+/- mobility)
2
Q
What are 3 routes of infection of acute septic arthritis?
A
- Haematogenous
- Eruption of bone abscess
- Direct invasion
3
Q
What are common causative organisms for acute septic arthritis?
A
- Staphylococus aureus
- Haemophilus influenzae
- Streptococcus pyogenes
- E. coli
4
Q
What is the 3 steps of pathogenesis for acute septic arthritis?
A
- Acute synovitis with purulent joint effusion
- Articular cartilage attacked by bacterial toxin and cellular enzyme
- Complete destruction of articular cartilage
5
Q
What is the prognosis for acute septic arthritis?
A
- Complete recovery
- Partial loss of the articular cartilage and subsequent OA
- Fibrous or bony ankylosis
6
Q
How would a neonate present with septicaemia due to acute septic arthritis?
A
- Irrability
- Resistent to movement
7
Q
How would a child/adult present with acute septic arthritis?
A
- Reluctant to move the joint
- Increased temperature and pulse
- Increase tenderness
8
Q
What investigations would we carry out for suspected acute septic arthritis?
A
- FBC, WBC, ESR, CRP, blood cultures
- X ray
- ultrasound
- aspiration
9
Q
What is the most common cause of acute septic arthritis in adults?
A
- Infected joint replacement
- Death can occur due to this but it is v rare (1%)
- Staph aureus still causative organism
10
Q
DDx for acute septic arthritis?
A
- Acute osteomyelitis
- Trauma
- Irritable joint
- haemophilia
- Rheumatic fever
- Gout
11
Q
Tx for acute septic arthritis?
A
- General supportive measures
- Antibiotics (3-4 wks)
- Staph. aureus (Flucloxacillin)
- MRSA (Vancomycin)
- Surgical drainage and lavage - emergency
- Infected joint replacements
