Septic Arthritis****

Question 1

When should you consider septic arthritis?

Why is it so important to recognise?

Answer 1

With someone with an acutely inflamed joint

It can rapidly destroy a joint

Question 2

S+S:

What will the joint be like?

What may they feel systemically?

Answer 2

Hot
Red
Swollen
Painful joint

Fever

Question 3

What STI could precede this?

Answer 3

Gonorrhoea - Neisseria gonococcus

Gonococcal arthritis

Question 4

Risk factors - list some

Answer 4

RA
DM
Immunosuppression
Kidney failure 
Joint replacement

Question 5

Investigations:

What needs to be done urgently to rule it in/out?

What blood would you do?

What needs to be done to investigate gonorrhoea if you suspect gonococcal arthritis?

What may you see on XR?

Answer 5

Joint aspiration - MC+S

FBC
CRP
Culture

Throat, urethral and rectal swabs

Usually normal - that is why joint aspiration is crucial

Question 6

Management:

What AB is used for staph. aureus?

What AB is used for MRSA?

What AB is used for gonococcal arthritis?

For how long?

How can the drainage of the joint be done?

FOLLOW LOCAL GUIDELINES AND THEY NEED TO BE REFERRED TO PROSTHETIC JOINT INVOLVEMENT

Answer 6

Flucloxacillin

Vancomycin

Cefotaxime

4-6 wks

Via needle
Via surgery