Septic arthritis Flashcards
What is septic arthritis?
infection of a joint
What are the main causative organisms of septic arthritis?
S aureus (adults), streptococcus spp, gonorrhea (sexually active), salmonella (sickle cell)
How will bacteria seed to the joint in septic arthritis?
bacteraemia e.g. recent cellulitis, UTI, Chest infection, direct inoculation or spread from adjacent osteomyelitis
What can septic arthritis cause irreversible damage to and what does this lead to?
Articular cartilage damage causing severe osteoarthritis
What are the risk factors for developing septic arthritis?
Over 80, pre existing joint disease, diabetes mellitus, immunosuppression, chronic renal failure, hip or knee joint prosthesis, IV drug use
What are the clinical features of septic arthritis?
single swollen joint causing severe pain, pyrexia
On examination how will septic arthritis present?
Red, swollen and warm, pain on active and passive movement, may have effusion, unable to weight bare, rigid
What are the differential diagnosis for septic arthritis?
Flare of osteoarthritis, haemarthrosis, crystal arthropathies (gout and psuedogout) RA, Reactive arthritis, lyme disease
What investigations should be done for septic arthritis?
routine bloods including FBC and CRP, with ESR and urate levels, blood cultures, joint aspiration before antibiotics are given, gram stained leucocyte count, polarising microscopy and fluid culture
What imaging should be done for septic arthritis?
Plain radiograph, may show capsule and soft tissue injury, fat pad shift, joint space widening, usually no other imaging but can do ultrasound guided joint aspiration, CT or MRI to check for mediastinum or pelvis extension, radionuclide scans
Wha is the management for septic arthritis?
resuscitation, antibiotic treatment for 4-6weeks orally or 2 weeks IV, surgical irrigation and debridement (washout)
What are the complications of septic arthritis?
osteoarthritis and osteomyelitis
