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-MSK Diseases > 5.3. Bone and Soft Tissue Infection - Acute Septic Arthritis > Flashcards

5.3. Bone and Soft Tissue Infection - Acute Septic Arthritis Flashcards

1
Q

What is the Route of Infection for Acute Septic Arthritis?

A
  1. Direct Invasion
  2. Eruption of a Bone Abscess
  3. Haematogenous (Blood) Spread
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2
Q

What are the different ways Acute Septic Arthritis can be spread, via Direct Invasion?

A
  1. A Penetrating Wound (Iatrogenic - Joint Injection)
  2. An Intra-Articular Injury
  3. Arthroscopy
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3
Q

What are the most common causative Organisms of Acute Septic Arthritis?

A
  1. Staph. Aureus
  2. H. Influenzae
  3. Strep. Pyogenes
  4. E. Coli
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4
Q

What is the Pathology of Acute Septic Arthritis?

A

Due to the infection:

  1. Articular Cartilage is attacked by the Bacterial Toxins and Cellular Enzymes
  2. This causes Acute Synovitis with Purulent Joint Efusion
  3. This leads to complete distruction of the Articular Cartilage
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5
Q

What are the recovery options (Sequelae) for Acute Septic Arthritis?

A
  1. Complete Recovery
  2. Partial Loss of the Articular Cartilage, and Subsequent Osteoarthritis
  3. Fibrous / Bony Ankylosis
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6
Q

What is the Clinical Presentation of Acute Septic Arthritis in a Neonate?

A
  1. Irritability
  2. Resistant to Movement
  3. Ill
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7
Q

What is the Clinical Presentation of Acute Septic Arthritis in a Child?

A
  1. Reluctance to move the Joint
  2. Increase in Temperature
  3. Increase in Pulse
  4. Increase in tenderness
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8
Q

Which joints does Acute Septic Arthritis most commonly present in Adults?

A

Superficial Joints:

  1. Knee
  2. Ankle
  3. Wrist
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9
Q

How common is Acute Septic Arthritis in healthy adults?

A

Rare

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10
Q

What are the investigations of Acute Septic Arthritis?

A
  1. Full Blood Count
  2. White Cell Count
  3. Inflammatory Markers - ESR + CRP
  4. Blood Cultures
  5. X-Ray
  6. Ultrasound
  7. Fine Needle Aspiration
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11
Q

What is the most common cause of Acute Septic Arthritis in an Adult?

A

An Infected Joint Replacement

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12
Q

What is the outcome of an Infected Joint Replacement?

A
  1. Removal or Arthroplasty
  2. Amputation
  3. Death
    Note this is very rare but disasterous
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13
Q

What is the Differential Diagnosis of Acute Septic Arthritis?

A
  1. Acute Osteomyelitis
  2. Trauma
  3. Irritable Joint Syndrome
  4. Haemophilia
  5. Rheumatic Fever
  6. Gout
  7. Gaucher’s Disease
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14
Q

What is the treatment of Acute Septic Arthritis?

A
  1. General Supportive Measures (Fluids + O2)
  2. Antibiotics
  3. Surgical Drainage and Lavage - emergency
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-MSK Diseases (43 decks)

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