Septic Arthritis Flashcards
Why is early diagnosis so important?
As it can destroy the joint completely in under 24hrs
When might the inflammation be less severe but still worth investigating for septic arthritis?
In immuno-compromised or there is predicting joint disease
Which joint is most commonly affected?
More than 50% of the time, the knee is affected
What are the risk factors for septic arthritis?
Diabetes, immunosuppression, pre-existing joint disease (especially RA) , chronic renal failure, recent joint surgery, prosthetic joints, IV drug abuse, age >80
What is the key investigation?
Joint aspiration and culture
What other investigations would you do?
XR, FBC, blood cultures
What are the main differentials?
Crystal arthropathies (gout and pseudogout)
What question must you ask yourself to help think of how this occurred?
How did the infection get there? Immunocomprimised? Surgery? Infected skin in area? Pneumonia?
What are the common causative bacteria?
Staph. a, streptococcus, n. gonnoccocus, gram -ve bacteria
What is the management?
Start empirical antibiotics, once sensitivities known give IV antibiotics for 2 weeks and rather PO antibiotics for a further 4 weeks
What antibiotic would you use for gram +ve?
Flucloxacillin
What antibiotic would you give if they have MRSA?
Vancomycin
What antibiotic would you give for gonnococal or gram -ve infection?
Cefotaxime
If HIV+ what should you look out for?
Atypical infection, mycobacteria or fungi
When would you consider arthritis?
Any joint that is acutely inflamed
