biological joint infections Flashcards
how can joints become infected
haematogenous route
directly following trauma or surgery
describe reactive arthritis
occurs due to enteric bacteria infections
pathogen responsible is at a distant site
usually more than one joint is affected
what is septic arthritis
infection of the joints causing arthritis
circulating bacteria sometimes localise in joints especially following trauma
5 risk factors for septic arthritis
age >80, children
joint damage from arthritis
prosthetic joint
skin infection
immunosuppression
what are the symptoms of SA
fever
joint pain
limitation of movement
swelling
joint effusion
what is the pathology of SA
haematogenous
dissemination of osteomyelitis
spread from adjacent soft tissue
puncture or injections
penetrating trauma
what is paediatric SA and why does is happen
children often have coexisting SA and osteomyelitis
thin bony cortex and loose periosteum
blood vessels that connect the metaphysis and epiphysis serve as a conduit by which bone infection may easily reach the joint space
what is osteomyelitis
bone can become infected haematogenously or by adjacent infection
typically involves growing end of a long bone where sprouting capillary loops adjacent to epiphyseal growth plates promote the localization of circulating bacteria
results in a painful tender bone lesion and a general febrile illness
how is osteomyelitis diagnosed
clinical: painful joints during exam or while taking history
microbial/radiological: normally through plainfilm - periosteal reaction and bone loss may be visible radiologically blood cultures/bone biopsy
what is septic bursitis
superfical bursae are commonly affected
underlying joint infection is not common
acute or repetitive trauma
staph aureas
can be treated by drainage or antibiotics
what is prosthetic joint infection
early or late onset
bacterial adhesion to biomaterial
cant be treated without removing material
DAIR procedure: debridement, antibiotics, irrigation, retention
two-stage revision
12 weeeks of antibiotics
high level of resistance
formation of BIOFILMS
what is arthrocentesis
a procedure used to remove synovia fluid accumulated around joints