Septic Arthritis

Question 1

Background
- Direct Infection
- Bacteria introduced
- Hematogenous

Answer 1

• Hematogenous – synovium is vascular so can be infected
• Direct infection – trauma
• Bacteria introduced into joint, synovium is infected and is vascular/sterile sites so bacteria is free to roam until PMN infiltration which causes pain/swelling occurring in first two days after bacteria joins, more pain/fever/swelling, can be chronic if not dealt with, joint and adjacent bone can be infected leading to more boney destruction, need early antibiotics

Question 2

Nongonococcal Bacteria

Answer 2

young/elderly/compromised patients, one joint (mono) - Knee MC, cultures are positive, most common bacteria is Staph aureus (clusters), Strep is also there then rarely gram negative

Question 3

Disseminated Gonococcal infection

Answer 3

Neisseria Gonorrhoeae
young/healthy adults
Triad: polyarthralgia, tenosynovitis, dermatitis
Knee/Wrist

difficulty walking

Question 4

Clinical Presentation

Answer 4

red, swollen, and painful, restricted ROM, cant bear weight

Question 5

Evaulation/Diagnosis

Answer 5

joint fluid aspiration, high WBC/ESR/CRP, surgery, XRAY

Question 6

Treat

Answer 6

– antibiotics 4-6 weeks, drainage, surgery, articular rest

Question 7

• Presentation of prosthetic joint

Answer 7

Presentation of prosthetic joint –fever/pain/erythema/swelling absent

o Caused by gram positive, Staph aureus or coagulase negative staphylococcus

o Evaluate – WBC normal, elevated sed rate and CRP, x-ray shows gradual loss of bone, scans more sensitive, needle aspiration (glucose low, protein/WBC high) and tissue biopsy are best

Question 8

chronic monoparticular arthritis

Answer 8

bacteria, eubacteria, fungi