Septic arthritis Flashcards
Who is septic arthritis most common in?
Neonates with transphyseal vessels, which allow for spread directly into the joint
What is septic arthritis?
This is an intra-articular infection of the hip joint
What are the most commonly affected joints in septic arthritis?
Joints wit intra-articular metaphysis include the hip, shoulder, elbow and ankle
What are the 2 most common bugs in septic arthritis of adults?
Staphylococcus aureus
Streptococci
What are some common bugs causing septic arthritis in children?
Haemophilus influenza - Pre-vaccine
Kingella kingae - arising problem
What is a common bug causing septic arthritis in young adults?
Neisseria gonorrhoea
What is a common bug causing septic arthritis in the elderly, PWID and the seriously ill?
Escherichia coli
What are some methods of spread to joints in septic arthritis?
Trauma
Surgery
Haematogenous spread
Spread from adjacent bone (Osteomyelitis)
How will septic arthritis present?
Septic arthritis will usually present as an acute monoarthropathy, in which there is a single warm, red, painful joint with pain whenever the joint moves
Patients may also have a systemic fever
What should red, hot, tender joints always be assumed to be until proven otherwise?
Any joint that is hot, red and tender is a septic joint until proven otherwise
What is the most commonly affected joint in septic arthritis?
Knee joint
What testing is required in suspected septic arthritis?
Aspiration
Blood testing
X-ray
MRI
Kocher’s criteria
What will blood tests show in septic arthritis?
raised CRP
Why is septic arthritis a surgical emergency?
A high bacterial load can cause sepsis, proteolytic enzymes can lead to destruction of the hip joint and there is a risk of osteonecrosis of the hip due to increased pressure
What is the treatment of septic arthritis?
Open surgical washout and specific antibiotics
Empirical antibiotics should be avoided unless patient is septic
