Septic Arthritis Flashcards
What is septic arthritis?
Infection of the joint
that damages articular cartilage and bone
What is the infection of septic arthritis associated with?
Most commonly bacterial
Can be viral or fungal
What are the causes of septic arthritis?
- Staphylococcus aureus or streptococci
- Direct injury to the joint
- Hematogenous spread
- Contiguous Osteomyelitis
- Rarely from arthrocentesis or arthroscopy
What is involved with hematogenous spread?
Pts with indwelling catheters
Immunocompromised
UTIs
What is important to know considering septic arthritis in IV drug users?
SC or SI joint
Pseudomonas aeruginosa
What is observed in PE of septic arthritis?
Very painful, red, hot swollen joint - Usually monoarticular - Knee- more that 50% of cases Decreased ROM \+/- fever
What imaging is used to diagnose septic arthritis?
Plain films
- Usually normal
- Soft tissue swelling; radiolucent lines if prosthetic joint infection
MRI
- Identify osteomyelitis
Bone Scan
- To evaluate for associated osteomyelitis
What labs are used in diagnosing septic arthritis?
Synovial Fluid Analysis
CBC w/diff
ESR
CRP
What will synovial fluid analysis in septic arthritis show?
WBCs > 50,000
Low glucose
High protein
What is important to know about ESR and CRP in septic arthritis?
High sensitivity, low specificity
CRP more specific and rises faster
What is the treatment of septic arthritis?
SURGERY
IV antibiotics
- Based on culture and sensitivity
- 4-6 weeks