Paediatric locomotor system Flashcards
- Definition of septic arthritis
infection inside a joint
- Septic arthritis most common in children under…. years
4 years
- Septic arthritis is a common and important complication of…
joint replacement. It occurs in around 1% of straight forward hip or knee replacements.
- Presentation of septic arthritis
usually single joint,a knee or hip. Rapid onset of:
- Hot, red, swollen and painful joint
- Refusing to weight bear
- Stiffness and reduced range of motion
- Systemic symptoms such as fever, lethargy and sepsis
- Limp
- Most common causative organism in septic arthritis + other organisms
Staphylococcus aureus is the most common causative organism.
Other bacteria:
- Neisseria gonorrhoea (gonococcus) in sexually active teenagers
- Group A streptococcus (Streptococcus pyogenes)
- Haemophilus influenza
- Escherichia coli (E. coli)
- Differential diagnosis to septic arthritis
- Transient sinovitis
- Perthes disease
- Slipped upper femoral epiphysis
- Juvenile idiopathic arthritis
- Investigations for septic arthritis
joint aspiration: for culture. Will show a raised WBC
Send the sample for gram staining, crystal microscopy, culture and antibiotic sensitivities
joint fluid may be purulent (full of pus)
raised inflammatory markers
blood cultures
- Management of septic arthritis
Empirical IV antibiotics until the microbial sensitivities are known.
Antibiotics continued for 3 to 6 weeks when septic arthritis is confirmed.
Choice of antibiotic depends on the local guidelines.
surgical drainage and washout of the joint to clear the infection in severe cases.
- The most commonly affected joints in septic arthritis
hip, knee and ankle
- Which criteria is used to diagnose septic arthritis? What are the components of the criteria?
The Kocher criteria for the diagnosis of septic arthritis:
* fever >38.5 degrees C
* non-weight bearing
* raised ESR
* raised WCC
