Joint Effusions Flashcards
Joint Effusion..
Fluid in the joint
4 Big causes of joint effusions
- Bursitis
- Blood
- Septic arthritis
- Gout
Bursitis
Inflammation of a bursal sace
What cause bursitis
Overuse
Bacteral/Fungi invasion
Blood/Hemophilia can be from
Trauma
Surgery
Anticoag
Medication
Septic Arthritis can be from
Bacterial invasion into joint space carried through the blood
Infect cartilage at end of the bone - can wear down in 24 hrs destroying the joint
Who is more vulnerable to have septic arthritis?
Peds due to more holes in bone (hip or knee)
Gout is from…
People who produce too much uric acid or don’t excrete it
What does too much uric acid form into?
Urate crystals
What do urate crystals cause?
Gouty tophi
Bulbous growths on your joints under your skin
Where is gouty tophi prominate?
Big toe because gravity pulls uric acid down
Bursitis needle aspiration
Clear/Straw colored
Blood needle aspiration
Red with RBCs
Septic Arthritis needles aspiration
Elevated WBC (100,000) Positive gram stain
Gout needle aspiration
urate crystals
Bursitis tx
NSAIDs
RICE
Steroids
Blood Tx
Aspiration
Direct Pressure
Underlying Cuase
Septic arthritis Tx
Sudden ONSET
Antibiotic therapy
Immobilize the Joint
Gout Tx
NSAIDs
Gout Rx
Gout Rx to reduce local inflammation
Cholcrys (Cholchicine)
Gout is worse..
at night
Gout Rx to increase urice acid excretions
Probenecid
Sulfinpyrazone (Anturane)
Gout Rx to reduce uric acid production
Allopurinol
What to Rx to avoid w/ Gout
Thiazide diuretics and ETOH (known to recirculate uric acid) worsens pt condition
