Rheum - septic arthritis, juvenile arthritis Flashcards
Name 3 organisms that can cause septic arthritis/osteomyelitis
Staph aureus
Strep pyogenes
Hib
Name 5 symptoms/characteristics that may distinguish between septic arthritis/osteomyelitis (but not always)
Timing of onset - septic arthritis more acute than osteomyelitis
Pain - both can have pain on movement, septic more likely at rest
Tenderness - OM has local tenderness
Soft tissue redness and swelling - more likely in septic arthritis
Fever - more likely in septic arthritis (can be both)
Name 4 Ix for septic arthritis/osteomyelitis
FBE X-ray Bone scan Blood culture ESR Joint aspirate
What 2 thins are most important for us to do if we suspect bone/joint infection?
Urgent referral to ortho
Elevate, immobilise limb
What is the definition of juvenile idiopathic arthritis? What type of disease is it? Name 3 symptoms
Arthritis for longer than 6 weeks before diagnosis in a person under 16 with no other cause. Autoimmune/inflammatory disease.
Symptoms - morning stiffness, decreased activity, surprisingly little pain
Name 8 questions on Hx of a child with an acutely painful/swollen hip (taken from RCH guidelines), and what diagnosis it points you to
Injury (trauma)
Significant pain/fever (septic arthritis)
Recent infection (reactive/post-infective arthritis)
Hx of IBD (enteropathic arthropathy)
Rash (vasculitis - HSP)
Medication ingestion (serum sickness, like after antibiotics)
Bone pain, lymphadenopathy, hepatosplenomegaly, constitutional symptoms (malignancy)
Symptoms of juvenile arthritis
What is the general management of a child with an acutely painful hip, irrespective of diagnosis
Reduce exercise/stress on hip, and NSAIDs for analgesia
Name 3 reasons to refer a child with painful joints to rheumatology
> 4 weeks symptoms Significant joint effusion Limitation of activity Multiple joints involved Joint contractures Non-HSP vasculitis Refractory to NSAIDs
