Septic Arthritis Flashcards
1
Q
Definition
A
.
2
Q
Epidemiology
A
.
3
Q
Pathophysiology
A
Route:
Heamatogenous (common)
Eruption of bone abscess (osteomyelitis)
Direct invasion
- Acute synovitis with purulent joint effusion
- Articular cartilage attacked by toxins (& cellular enzymes)
- Complete destruction of articular surface
4
Q
Etiology/Risk Factors
A
Stapylococus Aureus (common)
E.Coli (young & Old)
Streptococcus Pyogenes
Joint replacement (more = more likely)
5
Q
Presentation
A
Infants:
- Multifocal (full septic screening)
- Irritability
- Resists movements
Child/Adult:
- Pain on movement
- Reduced movement
- Swelling on superficial joint
- NO erythema till very late on
- Pyrexia & Tachicardia
6
Q
Lab Work Up
A
FBC (WBC, ESR, CRP)
Blood Cultures
Aspiration culture
7
Q
Imagining
A
X-Ray (late on)
Ultrasound (deep joint)
MRI
Aspiration (routine)
8
Q
Complications
A
.
9
Q
Differential Diagnosis
A
Acute Osteomyelitis Trauma Rheumatic fever Gout Gaicher's Disease
10
Q
Treatment
A
Supportive measures:
- Rehydration
Antibiotics (IV)
Surgical drainage
- After 24hours if no change
- If puss is present (remove neutrophils & toxins)
- Fixing prosthetic joint
11
Q
Prognosis
A
Can be a complete recovery if cause very early
Partial damage leads to OA
Complete damage leads to Fibrous or Bony ankylosis
12
Q
Histology
A
.
