Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

B - Paediatrics MANAGEMENT > Septic Arthritis > Flashcards

Septic Arthritis Flashcards

1
Q

What is septic arthritis?

A

Septic arthritis is a serious infection of the joint space, which can lead to bone destruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Who is septic arthritis most common in?

A

Children less than 2 years old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How many joints are affected in septic arthritis?

A

Usually only one joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What joints are most commonly affected in septic arthritis?

A

Knee > hip > ankle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What joint is of particular concern in septic arthritis in young children?

A

The hip

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What might septic arthritis result from?

A
  • Haematogenous spread (usual mechanism)
  • Puncture wound
  • Infected skin lesions, e.g. chickenpox
  • Spread of adjacent osteomyelitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When can septic arthritis result from the spread of adjacent osteomyelitis?

A

In young children

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What must be true of the joint in order for septic arthritis to have spread from adjacent osteomyelitis?

A

It must be a joint where the capsule inserts below the epiphyseal growth plate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the causative organisms for septic arthritis in children <12 months old?

A
  • S. Aureus
  • Group B streptococcus
  • Gram -ve bacilli
  • Candida albicans
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the causative organisms for septic arthritis in children aged 1-5 years?

A
  • S. Aureus
  • Haemophilus influenza
  • Group A streptococcus (pyogenes)
  • Streptococcus pneumoniae
  • Kingella kingae
  • Neisseria gonorrhoeae
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

When is haemophilus influenza causing septic arthritis rare?

A

In immunised children

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What does septic arthritis caused by neisseria gonorrhoae raise concerns of?

A

Child abuse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the causative organisms for septic arthritis in children aged 5-12?

A
  • S. Aureus

- Group A streptococcus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the causative organisms for septic arthritis in children aged 12-18?

A

S. Aureus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the risk factors for septic arthritis?

A
  • Immunodeficiency

- Sickle cell disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the problem with the diagnosis of septic arthritis in infants?

A

They typically do not appear ill, with 50% not having a fever

17
Q

What are the clinical features of septic arthritis in the older child?

A
  • Acute onset
  • Decreased range of movements or pseudoparalysis
  • Pain on passive motion
  • Hot, warm, swollen joint
  • Inability to weight bear
  • Systemic symptoms of infection
18
Q

When might the clinical picture in septic arthritis be less acute?

A

If the child has received antibiotics

19
Q

What investigations are done in septic arthritis?

A
  • Blood tests
  • Ultrasound of deep joints
  • X-ray
  • Aspiration of joint space
20
Q

What is found on blood tests in septic arthritis?

A

Increased WBC, ESR, and CRP

21
Q

What is the purpose of ultrasound of deep joints in septic arthritis?

A

Helpful to identify effusion

22
Q

What is the importance of x-ray in septic arthritis?

A

Exclude trauma and other bony lesions

23
Q

What may be shown on x-ray in septic arthritis?

A

Usually normal initially, but later signs include subluxation/dislocation, joint space narrowing, and erosive changes

24
Q

How is aspiration of the joint space performed?

A

Under ultrasound guidance

25
Q

What is the purpose of aspiration of the joint space in septic arthritis?

A

To get synovial fluid for organisms and culture

26
Q

What is the importance of aspiration of the joint space in septic arthritis?

A

It is the definitive investigation

27
Q

When is aspiration of the joint space ideally performed in septic arthritis?

A

Immediately, unless it would cause significant delay in giving antibiotics

28
Q

What further imaging may be useful in septic arthritis?

A
  • MRI scanning

- Radioisotope bone scan

29
Q

When might further imaging be useful in septic arthritis?

A

If the infection site is unclear

30
Q

What are the differential diagnoses of septic arthritis?

A
  • Transient synovitis
  • Rheumatic fever
  • Kawasaki disease
31
Q

What is the medical management of septic arthritis?

A

IV antibiotics for up to 3 weeks (until inflammatory markers normalise), followed by oral antibiotics for a total of 4-6 weeks

32
Q

What needs to be done before giving IV antibiotics in septic arthritis?

A

Aspirate needs to be taken

33
Q

What does the surgical treatment for septic arthritis involve?

A

Early referral to the orthropaedic team, with potential for irrigation and debridement of the affected joint

34
Q

Is there a low or high threshold for irrigation and debridement of the affected joint in septic arthritis?

A

Low

35
Q

Describe the use of splinting in septic arthritis?

A

A brief period of splinting may be useful in the acute setting to improve pain and allow inflammation to settle

36
Q

In what position should you split the joint in septic arthritis?

A

The position of function

37
Q

What is the use of physiotherapy in septic arthritis?

A

It may be useful to avoid joint stiffness

38
Q

What are the potential complications of septic arthritis?

A
  • Chondrolysis
  • Ongoing infection and bone destruction
  • Joint incogruity/stiffness
  • Growth disturbance
  • Avascular necrosis of femoral head

B - Paediatrics MANAGEMENT (106 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions