Joint infection Flashcards
1
Q
Causes of septic arthritis
A
- penetrating wound
- soft tissue infection
- sx
- hematogenous (more in foals)
2
Q
Why are foals more susceptible to septic arthritis?
A
- blood supply at capillaries at epiphysis is slow
3
Q
Signs of joint infection
A
- joint distention
- lameness
- per-articular edema
- cellulitis
4
Q
Dx methods
A
- US
- analyse synovial fluid
- culture joint fluid
- distend joint with fluid to look for leaks
- nuclear scintigraphy
- MRI
- CT
5
Q
Joint fluid changes in infection
If fungal?
A
- wBC > 30,000 cells/uL
- TP > 2.5
- neutrophil >90% of cells
- if fungal: high protein, lower WBC, +/- fluid red
6
Q
Drugs and proceedures that incr cell count in joint fluid
A
- arthrocetensis
- balanced electrolyte solution
- local anesthetic
- gentamicin
- DMSO
7
Q
Initial tx (before referal)
A
- is emergency so do ASAP
- analgesia
- systemic abx –> initially broad spectrum (B-lactam + aminoglycoside)
- local abx
- joint lavage
- NSAID
- +/- drain
8
Q
2 joint lavage options and when to use them
A
- needle lavage: acute cases, multiple joints
- arthroscopy: FB, foreign material
9
Q
2 ways to admin local abx
A
- intra-articular
- regional limb perfusion
10
Q
when to recheck joint
A
2d post proceedure
11
Q
Prognosis
A
- adults: good for survival, 50% for athleticism
- foals: 60%, worse if 2+ joints affected
12
Q
Septic physitis
- gross signs
- xray signs
- tx
A
- joint swelling
- incr lucency by physis
- sx debride
- if cannot reach, systemic and regional abx
13
Q
Osteomyelitis tx and prognosis
A
- lavage and curette
- aggressive abx
- reduces existing issue by 50%
