Septic Synovitis Flashcards

1
Q

what is normal total protein in synovial fluid?

A

<2.0 g/dl

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2
Q

what in nucleated cells in synovial fluid would indicate sepsis?

A

> 90% neutrophils

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3
Q

what is the prognosis of septic synovitis of the joint?

A

up to 85% returned to work

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4
Q

what vital structures can be compromised by a penetrating wound?

A

navicular bursa
coffin joint
digital tendon sheath
DDFT
coffin bone
navicular bone

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5
Q

what diagnostics can be done for septic synovitis?

A

arthrocentesis
distend joint with saline
radiographs
ultrasound

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6
Q

what is normal and septic total nucleated cell count in synovial fluid?

A

normal <500 cells/ul
septic >30,000 cells/ul

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7
Q

what percentage of synovial fluid cultures from truly infected joints will be positive?

A

60-75%

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8
Q

what are injection related infections like in terms of bacteriology?

A

coagulase positive Staph (S. aureus)
rarely polymicrobial

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9
Q

how long are systemic antibiotics usually administered for septic synovitis?

A

10-14 days

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10
Q

should you apply intra-articular anti-inflammatories for septic synovitis?

A

no- avoid for several months

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11
Q

what percentage of horses with tenosynovitis returned to work?

A

57-70%

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12
Q

is a street nail potentially life-threatening?

A

yes

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13
Q

what is a streetnail procedure like?

A

limited visualization of the bursa or joint
large defect created on the sole

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14
Q

what is the treatment of choice for a penetrating wound to thee hoof?

A

endoscopic lavage and debridement- navicular bursoscopy

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15
Q

when is conservative treatment of a penetrating wound to the hoof an option?

A

only for injuries sparing the joint/bursa/tendon sheath

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16
Q

what is the prognosis of a street nail if synovial structures are compromised?

A

endoscopic debridement: 60% return to athletic work
street nail procedure: 40%

17
Q

what are the options for local antibiotic therapy?

A

regional limb perfusion
intra-articular infusion
intra-osseous perfusion
antibiotic infusion systems
antibiotic impregnated implants

18
Q

what is regional limb perfusion excellent for?

A

septic synovitis
cellulitis
wounds

19
Q

what are the negatives of regional limb perfusion?

A

concentration dependent vs time dependent antibiotics
vessel thrombosis and perivascular swelling
time/safety

20
Q

what antibiotics are used in regional limb perfusion?

A

gentamicin
amikacin
naxcel
baytril
imipenem
cefotaxime
ceftazidime
vancomycin