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LAS > Septic Arthritis > Flashcards

Septic Arthritis Flashcards

1
Q

true or false: septic arthritis is usually bacterial

A

true

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2
Q

what should you always check in foals with septic arthritis?

A

US umbilicus

palpate ALL joints to see which are involved

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3
Q

normal synovial fluid:

  • appearance
  • WBC count
  • diff neutrophil count
  • TP
A

normal:

  • appearance: clear, pale yellow
  • WBC <500 cells/dL
  • diff <10% neutrophils
  • TP <2 g/dL
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4
Q

risk factors for septic arthritis in foals

A

failure of passive transport
normal = >800
partial failure = 400-800
failure = <400

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5
Q

signs associated with P type septic arthritis in foals

A

periarticular swelling usually WITHOUT joint distension or effusion

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6
Q

diagnosing septic arthritis (3)

A
  • microbiology (send in blood culture media)
  • gross exam of synovial fluid
  • clin path of synovial fluid (cell count, TP, smear)
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7
Q

treatment for septic arthritis

A

-Lavage MOST IMPORTANT: early + often + big volumes (5-10 L) until signs are gone
-arthroscopic is best because can debride but
requires GA
-needle through and through method: not as
targeted but can be done standing. Requires
LARGE needle (14, 16, or 18 G)
-use balanced electrolyte solution (LRS, normosol,
plasmalyte) +/- DMSO
-saline is last resort
-DO NOT use antiseptics (not effective + cytotoxic)
-broad spectrum antibiotics if needed (penicillin, gentamycin)

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8
Q

what might you see on US for septic arthritis?

A

hypercellular joint fluid

***also always check umbilicus for foals

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9
Q

G.S. for diagnosing septic arthritis

A

microbiology (send in blood culture media; good idea to also send for fungal; repeat a second time if first time is negative; ideally culture BEFORE antibiotics/treatment)

staph is most common

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10
Q

E type septic arthritis in foals:

  • what does it affect?
  • age?
  • number of joints involved?
A
  • epyphysis/bony involvement (rads show subcondral lysis)
  • weeks old
  • usually multiple joints involved
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11
Q

normal fibrinogen in horses? what level might you see with septic arthritis if bone involved?

A

normal: <400 mg/dL

if bone involved often >900 mg/dL

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12
Q

diagnosis of septic arthritis in foals (5)

A

-rads
-BW:
-fibrinogen usually >900 mg/dL when bone is
involved (normal is <400)
-+/- leukocytosis
-US: hypercellular fluid
-***always also check umbilicus
-synovial fluid aspirate (aspirate physis if p type):
-cell count >50,000
-neutrophils >90%
-color: normal to cloudy/red/orange/pink
-palpate ALL joints to see which are involved

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13
Q

most common organism cultured during septic arthritis cases

A

staph

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14
Q

types of septic arthritis in foals

A
  • S type (affects synovial membrane and fluid)
  • E type (epiphysis/bone involved)
  • P type (physis involved)
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15
Q

complications of septic arthritis

A
  • contralateral limb laminitis
  • DJD
  • ankylosis
  • euthanasia
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16
Q

E type septic arthritis in foals:

  • signs?
  • most commonly affected sites?
  • number of joints usually involved?
A
  • signs: rads show subcondral lysis, history of FPT or disease, MILD lameness THEN acute exacerbation of lameness/effusion
  • distal femur, talus, tibia, radius
  • usually multiple joints involved
17
Q

septic arthritis secondary to trauma is most commonly _____ in origin

A

enterobacter

also can be staph, pseudomonas, fungal

18
Q

what important things to remember about lavaging septic joints? what two methods can you use?

A

-Lavage MOST IMPORTANT: early + often + big volumes (5-10 L) until signs are gone
-arthroscopic is best because can debride but
requires GA
-needle through and through method: not as
targeted but can be done standing. Requires
LARGE needle (14, 16, or 18 G)
-use balanced electrolyte solution (LRS, normosol,
plasmalyte) +/- DMSO
-saline is last resort
-DO NOT use antiseptics (not effective + cytotoxic)

19
Q

septic arthritis secondary to arthrocentesis is usually ______ in origin

A

staph

20
Q

S type septic arthritis:

  • most common joints involved?
  • number of joints usually involved?
  • C.S.?
A
  • signs: acute SEVERE lameness, effusion
  • usually multiple joints involved
  • common sites: usually larger joints (stifle, tibiotarsal)
21
Q

causes of septic arthritis in horses

A
  • trauma (usually enterobacter; also staph, pseudomonas, fungal)
  • hematogenous (usually only foals)
  • iatrogenic (usually staph)
22
Q

P type septic arthritis in foals:

  • age?
  • common sites?
  • number of sites common?
A
  • age: older (weeks to months)
  • number of sites: usually one physis
  • common sites: distal physis of MCIII/MTIII, radius, tibia
23
Q

difference in presentation between S type and E type of septic arthritis in foals

A

S type: SEVERE lameness; usually no bone involvement; just synovial membrane and fluid; usually <1 week

E type: bone involved, usually MILD lameness THEN acute exacerbation of lameness/effusion; usually weeks old with history of FPT or disease

both usually involve multiple joints

24
Q

what size needle do you need to lavage septic joints using needle through and through method?

A

14, 16, or 18 G

25
Q

S type septic arthritis in foals:

  • what does it affect?
  • age?
  • number of joints involved?
A
  • affects synovial membrane and fluid;
  • usually < 1 week old
  • usually multiple joints involved
26
Q

true or false: you should NEVER debride a physis

A

TRUE

27
Q

abnormal synovial fluid parameters:

  • appearance
  • WBC count
  • diff neutrophil count
  • TP
A
  • turbid, serosanguinous
  • WBC: thousands +
  • > 90% neutrophils
  • > 3.5 g/dL

LAS (51 decks)

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