Acute Septic Arthritis

Question 1

What are the routes of infection is septic arthritis?

Answer 1

Penetrating wound
Bone abscess rupture
Haematogenous spread

Question 2

Two types of gram +ve bacteria in septic arthritis?

Answer 2

Staph aureus

Strep pyogenes

Question 3

Two types of gram -ve bacteria in septic arthritis?

Answer 3

E.Coli

Haemophilus influenza

Question 4

Pathophysiology of septic arthritis?

Answer 4

Acute synovitis

Purulent joint effusion

Question 5

What causes the acute synovitis?

Answer 5

Bacterial toxin

Cellular enzymes

Question 6

What are the chronic results of total distruction of articular cartilage and partial recovery

Answer 6

OA

Ankylosis (google)

Question 7

Clinical features of a child with ASA?

Answer 7

Irritability

Resistance to movement

Acute pain in SINGLE LARGE JOINT

Reluctant to move

Question 8

General symptoms of ASA?

Answer 8

Fever
Tachycardia
Malaise

Question 9

Child joints affected in ASA?

Answer 9

Large joint

Question 10

Adult joints affected in ASA?

Answer 10

Superficial joints

• Ankle
• Wrist
• Knee

Question 11

What blood investigations for suspected ASA?

Answer 11

Culture
ESR
WCC

Question 12

What other investigations?

Answer 12

X ray
USS

ASPIRATION!!!!

Question 13

What investigation should be done to rule out gout?

Answer 13

Birefringence on polarised microscopy

Question 14

If non septic, what should be done before starting treatment?

Answer 14

Aspiration

Question 15

What should treatment of suspected sepsis be?

Answer 15

SEPSIS 6

Question 16

What is the sepsis 6?

Answer 16

ALL PERFORMED WITHIN 1 HOUR

• IV Fluids
• Oxygen
• Broad spectrums
• Lactate
• Blood culture
• Catheterisation

Question 17

What is the treatment of gram +ve septic arthritis?

Answer 17

Vancomycin

Question 18

What is the antibiotic treatment of gram -ve arthritis?

Answer 18

Ciprofloxacin

+cephalosporins if E coli

Question 19

What should be done to the joint as well as antibiotics

Answer 19

Aspiration