Septic Arthritis

Question 1

P

Answer 1

Sraphylococcus aureus
Staphylococcus epidermis
Gram -ve bacillin in diabetics, elderly, IVDU

Question 2

A

Answer 2

Pre-existing joint disease
DM
Immunosuppression
Chronic renal failure
Recent joint surgery
Prosthetic joints
IV drug use
Age > 80

Question 3

S

Answer 3

Red hot swollen painful joint
Joint immobility
Tachycardia, fever, rash

Kocher criteria
Non-weigth bearing
Raised ESR
Fever
Raised WCC

Question 4

Ix

Answer 4

Urgent joint aspiration for synovial fluids MC&S, Gram stain, WCC, polarised light microscopy

Blood culture

FBC
ESR

Main DDx:
Gout
CPPD\

Question 5

Mx

Answer 5

Empirical IV abx:
Flucloxacillin
Vancomycin for MRSA
Pen allergy IV clindamycin

Cefotaxime for Gram -ve or sexual disease

Continue for 6 weeks

Orthopaedic review for arthrocentesis, lavage, debridedment
Joint immobilisation
PT