Acute Septic Arthritis

Question 1

What is Acute Septic Arthritis?

Answer 1

Inflammation of a joint caused by a bacterial infection.

AKA, Infectious / Bacterial Arthritis

Question 2

What joints can be affected by acute septic arthritis?

Answer 2

Most common in Hips and Knees.

Almost any joint can be affected.

Question 3

What are risk factors for Septic Arthritis? (5)

Answer 3

Drug Abuse
Diabetes
Immunosuppression
Elderly
Pre-Existing Joint Disease

Question 4

What is the most common cause for Infectous Arthritis?

Answer 4

Infection of joint replacement.

Affecting 1.5% of the adults.
Usually Staphylococcus Aureus.

Question 5

What are the worst prognoses associated with Septic Arthritis? (3)

Answer 5

DEATH

Amputation

Removal of Arthroplasty

Question 6

What are the 4 main organisms associated with Acute Septic Arthritis?

Answer 6

• Staph Aureus
• Strep Pyogenes
• H. Influenza
• E. Coli

Question 7

What are the common routes of infection for Acute Septic Arthritis? (4)

Answer 7

• Haematogenous
• Bone Abscess eruption
• Direct Invasion of Joint
• Metaphyseal Septic Focus

Question 8

How does acute septic arthritis present?

Answer 8

Acute pain in a single large joint.

Increased Pulse, Tenderness and Temp.

N.B. children presenting limping may have septic arthritis.

Question 9

What investigations can you conduct for Acute Septic Arthritis? (7)

Answer 9

Bloods = FBC, WCC (Raised>12,000/mm3),

ESR (>50mm/hr),

CRP,

blood cultures (+ve in 30-50%)

X-ray

Ultrasound

Aspiration

Question 10

What are some symptoms that a clinician may consolidate when predicting outcome of Acute Septic Arthritis? (6)

Answer 10

• Fever?
• Ability to bear weight
• ESR
• CRP
• Serum White Cell Count
• Joint Space

Question 11

What is the course of treatment for Acute Septic Arthritis?

4

Answer 11

Emergency: Surgical drainage and Lavage

Antibiotics (3-4 weeks)

Arthroscopy
Arthrotomy (knee, shoulder or ankle)