Septic arthritis Flashcards
What is the definition of septic arthritis?
MEDICAL EMERGANCY. Inflammation of a joint due to a bacterial infection
How common is septic arthritis?
Semi common
What is the pathophysiology of septic arthritis?
- Knee is affected in >50% of cases
- Common causative organisms: Staph aureus, streptococci, Neisseria gonococcus
- Infection via direct injury, contagious spread from infected periarticular tissue or blood borne infection
What are the risk factors/aetiology of septic arthritis?
- Pre existing joint disease – esp. rheumatoid arthritis
- Diabetes
- Pneumonia → pneumococcal arthritis
- Immunosuppression
- Chronic renal failure
- Recent joint surgery
- Recent intra-articular steroid injection
- Prosthetic joints
- IV drug abuser
- > 80 years of age
What are the signs/symptoms of septic arthritis?
- Acute onset
- Single joint normally
- Hot joint
- Painful joint on active and passive movement
- Swollen joint
- Red joint
- Wound inflammation
- Discharge
- Joint effusion
- Loss of function of joint
- Fever/rigors
- Vomiting
- Hypotension
What conditions present similarly to septic arthritis?
- Other types of arthritis
- Crystal arthropathies
- RA/OA
What investigations are required in suspected septic arthritis?
- Urgent joint aspiration for synovial microscopy and culture
- FBC
- ESR
- CRP
- Blood cultures
What is the surgical treatment for septic arthritis?
- Arthrocentesis
* Lavage and debridement
What are the pharmacological treatments for septic arthritis?
• IV antibiotics – flucloxicillin/vancomycin/cefotaxime
What are the non pharmacological treatments for septic arthritis?
- Analgesia
* Immobilise joint