Rad L6: Septic Arthritis Flashcards Preview

CHI303:clinical Science And Diagnosis > Rad L6: Septic Arthritis > Flashcards

Flashcards in Rad L6: Septic Arthritis Deck (18):
1

How does infection enter the body (bone /joint) in Septic Arthrisis (Suppurative)?

  • organisms enter from direct implantation (stab wound-dirty knife), blood or extension from adjacent bone infection.

2

What happens to the synovial joint during SA (suppurative)?

  • capsular distention --> cartilage death and destruction
  • loss of cartilage causes joint destruction and bone involvement

3

What is the most common organism in SA (suppurative)?

staph. aureus  

4

Which joints, and how many are commonly involved in SA (suppurative)?

  • monoarticular 
  • hip/knee joints 


     

5

What clinical features, and lab tests are involved in SA (suppurative)?

  • decreased ROM due to pain and capsular edema
  • periarticular soft tissue swelling
  • may see fever, chills, erythema
  • labs show elevated ESR, leukocytosis and + culture 

6

What is the incidence of skeletal infections invoving the spine in SA (Intervertebral Discitis-suppurative)?

2-4%

7

What is the most commonly affected region of the spine in SA (Intervertebral Discitis-suppurative)?

Lumbar spine

8

What may you find in the patients history, and what are some common/uncommon clinical findings in SA (Intervertebral Discitis-suppurative)?

  • History: previous visceral infection or surgery
  • Common: insidious onset of back pain - may be radicular
  • Uncommon: fever 

9

What is the latent period for osseus changes in SA (Intervertebral Discitis-suppurative)?

21 days

10

What is the treatment for SA (Intervertebral Discitis-suppurative)?

antibiotic therapy, usually intravenous

early diagnosis is key to successful Tx 

11

What is the main cause (etiologyfor SA (Non-suppurative)?

Tuberculosis (TB)

12

Describe the incidence of SA (Non-suppurative)?

  • had been decreasing, has stabilized, now increasing in some regions of the world
  • low socioeconomic status higher risk

13

What are the clinical features of SA (Non-suppurative)?

  • course is insidious and resistantly destructive
  • insidious onset back pain
  • tenderness in spine
  • joint swelling, increased temp. decreased motion-hard to see in spine 
  • muscle atrophy
  • limp seen in extremities

14

What are some Pathologic/Radiologic signs of SA Non-suppurative: Tuberculous Spondylitis?

m.c. level involved

pathogenesis:

  • similar to suppurative infection
  • a slower process than suppurative infection, so more sclerosis and bony reaction is seen

Radiology:

  • amount of destruction can be severe --> Pott’s spine (severe gibbus deformity)
  • L1

  • may see paraspinal line deviation from spinal abscess
     



  • subligamentous spread may lead to anterior vertebral body erosion, psoas (cold) abscess, additional joint involvement (disc, hip).  The abscess may calcify.











     

15

How many joints are typically involved in SA (Non-suppurative)?

 

Polyarticular joint involvement

Most distinguishing factor between suppurative and non-suppurative

16

What are some Pathologic/Radiologic signs of SA Non-suppurative: Tuberculous Arthritis?

 

Pathologic:

  • initial infection starts in bone, then spreads to joint

Radiologic:

  • changes are primarily joint related, with adjacent bone destruction later on
  • Phemister’s triad = slowly progressive loss of joint space, juxta-articular osteoporosis, articular erosions (hip)
  • may result in fibrous ankylosis

17

What is the treatment for SA Non-suppurative?

Chemotherapy and debridement*

 

*the removal of dead, damaged or infected tissue)

18

What is the key radiographic presentation for any joint infection?


  • relatively rapid joint destruction

  • irregular subchondral bone destruction