Lecture 24 4/1/25 Flashcards
What are the characteristics of septic arthritis?
-fairly common
-more often seen in young animals
-greater incidence in dairy than beef cattle
What are the etiology types for septic arthritis?
type 1: direct trauma
type 2: close proximity (wound next to joint)
-type 3: hematogenous (most common)
What are the two types of infections that can lead to septic arthritis?
*synovial infections
-septic arthritis
-tenosynovitis
*bone infections
-sequestrum
-pedal osteitis
-osteomyelitis
What is the clinical presentation of septic arthritis?
-severe pain
-joint distention
-variable degree of lameness
Which joints are most commonly affected by septic arthritis?
-fetlock
-carpus
-tarsus
-stifle
-P2/P3
How is septic arthritis diagnosed?
-joint distention +/- pain
-radiography
-ultrasonography
-arthrocentesis with cytology and culture
What is important regarding arthrocentesis?
it must be done under sterile technique, otherwise there is an increased risk of introducing an infection into the joint
What are the characteristics of a joint tap?
-sterile procedure done with surgical prep.
-use 18G needles
-collect fluid sample
-evaluate both cytology and refractometry
What aspects of joint tap analysis give a good indication of a septic joint?
-80% or more cells being neutrophils
-total protein greater than 4.5 g/dL
Which culture types should be requested for joint tap analysis?
-aerobic
-anaerobic
-mycoplasma
What are the two methods of joint lavage?
-through and through
-tidal irrigation/pushing and retrieving fluid
What are the characteristics of arthrotomy
-make a 3/4” incision
-scoop out pus and fibrin clots within joint
-must heal incisions via second intention
What are the characteristics of arthroscopy?
-best way to clean the joint
-can use lots of fluid
-expensive3
What are the physical treatment options for septic arthritis?
-joint lavage
-arthrotomy
-arthroscopy
-facilitated ankylosis
-amputation
What are the characteristics of antibiotic therapy as a medical treatment for septic arthritis?
-no antibiotic is approved for septic arthritis
-want to target the most probable bacteria
-need appropriate diffusion; macrolides and florfenicol have best diffusion, while tetracyclines can penetrate bone
-can do IV, IM, or RLP
-choose schedule based on animal’s needs, temperament, etc.
What are the characteristics of RLP for septic arthritis treatment?
-increases concentration of antibiotic in distal aspect of limb
-limited antibiotic choices; most IV antibiotics are time-dependent, RLP requires concentration-dependent antibiotic
How is pain controlled in septic arthritis?
-NSAIDs for pain and inflammation
-typically meloxicam or banamine
-steroids are controversial
What is the main sign of healing in septic arthritis?
comfort and return to weight bearing
What are the other potential orthopedic infections besides septic arthritis?
-open fracture and infection
-bone sequestrum
-physitis
-osteomyelitis
-septic tenosynovitis
What is the take home message regarding open fractures?
-prognosis is poor
-treatment is expensive
What are the treatment steps for septic physitis?
-curettage of infected bone
-antibiotics
-stabilization
-multimodal pain control
