Septic Arthritis Flashcards
What is septic arthritis?
It is a condition in which bacteria invade the joint space, most often the hip or knee. It can occur at any age but usually occurs in children younger than 3 years old
How is it transmitted?
Usually bacteria gain access to the joint through the bloodstream but can be due to direct puncture from injections, venipuncture, wound infection, surgery, or injury.
What are the s/s?
- fever
- pain
- refusal to bear weight or straighten the joint, and limited range of motion (the child usually maintains the joint in flexion and will not allow the leg to be straightened). The child will generally hold the joint in a position of comfort and the child or infant will appear without pain as long as the joint is immobile.
- warmth and swelling
- wound
Labs and Diagnostic Tests
- White blood cell count normal or elevated with elevated neutrophil counts.
- Elevated erythrocyte sedimentation rate and C-reactive protein levels.
- Fluid from joint aspiration demonstrates elevated white blood cell count; culture determines responsible organism.
- Joint radiograph may show subtle soft tissue changes or increase in the joint space.
- Positive blood culture for the causative organism (15% of cases)
Treatments
- joint aspiration or arthrotomy
- IV antibiotics or oral at home
- Tylenol or ibuprofen for pain
The goals of treatment of septic arthritis are to prevent destruction of the joint cartilage and maintain function, motion, and strength
What are the complications?
Sepsis of the hip joint may cause avascular necrosis of the femoral head due to pressure on blood vessels and cartilage within the joint space. Septic arthritis is considered a medical emergency, as destruction of the joint cartilage may occur within just a few days. Additional complications of septic arthritis include permanent deformity, leg-length discrepancy, and long-term decreased range of motion and disability.
