SEPTIC ARTHRITIS

Question 1

DEFINE

Answer 1

PURULENT INFLAMMATION OF THE JOINT CAUSED BY MICROORGANISM

Question 2

ETIOLOGY

Answer 2

STAPH AUREUS
STREPTOCOCCUS
E COLI
PSEUDOMONAS
KLINGELLA
H . INFLUENZA

Question 3

ROUTE OF INFECTION

Answer 3

HEMATOGENOUS
SECONDARY TO NEARBY OSTEOMYELITIS
DIRECT INVASION BY MICROBES

Question 4

SYMPTOMS

Answer 4

SEVERE THROBBING PAIN
COMMONLY AFFECTED KNEE
IF CHILD - HIP IS MORE COMMONLY AFFECTED
FEBRILE
SWELLING AND REDNESS OF JOINT
PAINFUL LIMP
INABILITY TO USE AFFECTED LIMB

Question 5

SIGNS

Answer 5

FEVER
TACHYCARDIA
FAILURE TO THRIVE
TOXIC LOOK
TENDER SWELLING
PSEUDOPARALYSIS
AFFECTED JOINT HELD IN POSITION OF EASE

Question 6

IMAGING

Answer 6

X RAY
USG
MRI
JOINT ASPIRATION

Question 7

X RAY

Answer 7

SOFT TISSUE SWELLING
INCREASE JOINT SPACE
SUBLUXATION
GAS IN JOINT DUE TO ECOLI
LATE STAGE - NARROWING OF JOINT, CARTILAGE DESTRUCTION

Question 8

USG

Answer 8

EARLY CASE - JOINT EFUSION
WIDENING OF SPACE BETWEEN JOINT AND CAPSULE > 2MM INDICATES EFFUSION

Question 9

BLOOD

Answer 9

HIGH ESR , LEUCOCYTOSIS

Question 10

TREATMENT

Answer 10

GENERAL SUPPORTIVE CARE
SPILINTAGE
ANTIBIOTIC
DRAINAGE

Question 11

GENERAL SUPPORTIVE CARE

Answer 11

ANALGESIC
IV FLUIDS FOR HYDRATION

Question 12

SPLINTAGE

Answer 12

TRACTION

Question 13

ANTIBIOTICS

Answer 13

LESS THAN 6 MONTHS -
FLUCLOXACILLIN+ 3RD GEN CEPHALOSPORIN
6 MONTHS TO PUBERTY -
FLUCLOXACILLIN+ 3RD GEN CEPHALOSPORIN
ADOLESCENCE AND ADULTS -
FUSIDIC ACID + FLUCLOXACILLIN
IF GRAM STAIN SHOWS GRAM NEGATIVE ORGANISM , 3RD GEN CEPHALOSPORIN ADDED

Question 14

COMPLICATION

Answer 14

SUBLUXATION / DISLOCATION
DAMAGE TO PHYSIS
ARTICULAR CARTILAGE EROSION
ANKYLOSIS
OSTEOARTHRITIS

Question 15

DRAINAGE

Answer 15

UNDER ANESTHESIA - JOINT OPENED BY SMALL INCISON , DRAINED AND WASHED WITH NORMAL SALINE .
SMALL CATHETER PLACED , WOUND CLOSED, SUCTION IRRIGATION CONTINUED
FOR KNEE - ARTHROSCOPIC DEBRIDEMENT DONE
CLOSED ASPIRATION - CHILDREN , LESS THAN 3 DAYS OF SYMPTOMS