Septic Arthritis - Week 5 PBL

Question 1

What is septic arthritis?

Answer 1

Acute infection within a synovial joint

Question 2

Presentation of septic arthritis?

Answer 2

Red and hot swollen joint
Stiffness
Reduced range of motion
Systematically unwell
Acute onset

Question 3

Risk factors of septic Arthritis

Answer 3

Immunosuppressed
IV drug user
HIV
Cellulitis overlaying joint
Diabetes
Joint trauma/surgery

Children under 2

Question 4

Investigations for septic arthritis?

Answer 4

Synovial joint aspiration ASAP
gram stain, culture and microscopy:

Purulent dischage
High WBC count (>50,000)
Gram staining shows bacteria

Question 5

Common pathogens for septic arthritis?

Answer 5

Staphylococcus aureus gram Pos (if in doubt)
Neisseria gonorrhoea (young sexually active adult)

Group B strep

Streptococcus pyogenes
E. coli

Question 6

Management of septic arthritis?

Answer 6

Surgical joint wash out

IV antibiotics (Flucloxacillin, Vancomycin if allergic to penicillin or clindamycin)

Then use the antibiotic that the bacteria is sensitive too

Question 7

Why does investigation and management of septic arthritis have to be fast?

Answer 7

To prevent irreversible joint destruction
And to prevent ischaemia happening due to swelling in joint

Question 8

Sources of infection for septic arthritis?

Answer 8

Haematogenous
Post trauma
Post surgery

Question 9

What criteria helps with likelihood of septic arthritis?

Answer 9

Kocher criteria