Septic Arthritis Flashcards
Define Septic Arthritis?
Acute joint inflammation resulting from intra-articular infection
Can destory a joint in under 24hrs
Usually affects the knee
What is the aetiology of Septic Arthritis?
May be idiopathic
In most cases there is a systemic infection allowing for haematogenous spread
What are the risk factors for Septic Arthritis?
Recent orthopaedic procedures Osteomyelitis Diabetes Mellitus Rheumatoid arthritis Chronic renal failure Prosthetic joints - infection here is particularly difficult to treat Immunosuppression Alcoholism
What bacteria normally cause Septic Arthritis for people of all ages?
Staphyococcus aureus
TB
What bacteria normally causes Septic Arthritis in children less than 4 years old?
Streptococcus pneumoniae
Streptococcus pyogenes
Neisseria meningitidis
Gram-negative rods
What bacteria cause Septic Arthritis in people aged 16-40?
Neisseria gonorrhoeae
What viruses cause Septic Arthritis?
Rubella
Mumps
Hep B
Parvovirus B19
What fungi cause Septic Arthritis?
Candida
What is the epidemiology of Septic Arthritis?
Most common in CHILDREN and the ELDERLY
What are the presenting symptoms of Septic Arthritis?
Sudden onset Fever Excruiating joint pain Joint redness Swelling Loss of joint function Usually a monoarthopathy but can cause a polyarthopathy in the immunosuppressed Tuberculous arthritis develops more slowly and is more chronic
What is the nature of the loss o
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What are the signs of Septic Arthritis on physical examination?
Painful, hot swellen Immobile joint Erythema Severe pain prevents passive movement Pyrexia Look for signs of aetiology
What is the first line investigation for Septic Arthritis?
Urgent Joint Aspiration
What do we do with the Urgent Joint Aspiration in Septic Arthritis?
The aspirate will be grossly purulent
Send synovial fluid for MC&S - do microscopy to rule out crystal arthritis
PCR may be used if a viral cause is suspected
What other investigations do you do for Septic Arthritis?
Bloods
Plain joint radiographs
MRI scan
