Septic arthritis Flashcards
(11 cards)
What is septic arthritis?
Infection inside a joint.
Can occur at any age, most common in children under the age of 4.
Why is septic arthritis considered an emergency?
The infection can quickly begin to destroy the joint, causing permanent damage and serious systemic illness.
What can septic arthritis be a complication of?
Joint replacement.
The percentage is higher in revision surgery.
What does septic arthritis usually affect?
Usually only a single joint, often a knee, hip, or ankle.
What are the symptoms of septic arthritis?
Joint pain, limp, fever, systemically unwell: lethargy.
Can be subtle symptoms in children.
What are the signs of septic arthritis?
Hot, red and swollen joint, refusing to weight bear, stiffness and RROM, fever, sepsis features.
What criteria is used to assess the probability of septic arthritis?
Kocher criteria: fever >38.5, non weight bearing, raised ESR, raised WCC.
What are common causative bacterial causes of septic arthritis?
Staphylococcus aureus is the most common causative organism.
Other causes include Neisseria gonorrhoea, Group A streptococcus, Haemophilus influenza, and Escherichia coli.
What are the differentials of septic arthritis?
Transient synovitis, Perthes disease, slipped upper femoral epiphysis, juvenile idiopathic arthritis.
What investigations are done for septic arthritis?
Joint aspiration for culture will show a raised WBC, raised inflammatory markers, blood cultures.
What is the management of septic arthritis?
Low threshold for treating septic arthritis, especially cautious with immunosuppressed patients.
Joint should be aspirated prior to giving antibiotics when possible; send the sample for gram staining, crystal microscopy, culture, and antibiotic sensitivities. Empirical IV antibiotics given until microbial sensitivities are known, usually continued for 3-6 weeks when septic arthritis is confirmed. Surgical drainage and washout of the joint may be needed in severe cases.
