Septic and reactive arthritis Flashcards
What is sepsis
Failure of one or more organs due to over-reaction to infection
What is septicemia?
Presence of bacteria in the blood
What is septic shock?
Most severe outcome of sepsis involving vascular collapse, 50% mortality
how can joints become infected?
Haematogenous route or directly following trauma/surgery
What is reactive arthritis
An aseptic arthritis occurring following an anatomically distant infection
What are the symptoms of reactive arthritis
Stiffness, fatigue, fever, pain
Conjunctivitis, urethritis, skin/mucosal lesions,.
Which joints does reactive arthritis affect
Large weight bearing, fingers and toes. Asymmetrical, oligoarticular
What do blood tests show for reactive arthritis
FBC, ESR and CRP akin to ankylosing spondylitis. Serological tests mey help find antigens of causative organism (Salmonella, campylobacter, chlamydia etc)
Is reactive arthritis linked to the HLA B27 gene?
yes
What must be done to eliminate possibility of septic arthritis for a reactive arhtritis diagnosis?
Aspiration of the joint synovial fluid. Cervical/penile swab or MSU sample also help exclude infection.
How is reactive arthritis treated?
Underlying infection treated with antibiotics. Otherwise, NSAIDs, corticosteroid injections, rarely DMARDs
What is septic arthritis?
Infection within a synovial joint
How can infection spread to a joint?
Haematogenous route, Dissemination from OM Spread from adjacent soft tissue Puncture or injections (corticosteroids) Penetrating trauma
How does septic arthritis present
Hot swollen joint, fever, systematically unwell. More common in hip/knee but can be any. Any movement causes intense pain
What does bloods show
Elevated WCC ESR CRP
