Swollen joint Flashcards
(12 cards)
How does acute arthritis present?
Pain Swelling Heat Redness Restricted mouvement
What is reactive arthritis?
What does it follow?
Transient joint swelling (<6w) of ankles or knees (asymmetrical)
Can accompany urethritis, conjunctivitis
Usually follows extra-articular infection:
Post-dysentry:
Shigella, Salmonella, Yersina, Campylobacter
Post STI:
Chlamydia trachomatis
What is Reiter’s syndrome?
Urethritis
Conjunctivitis
Reactive arthritis
Cant see, pee or climb a tree
What is management of reactive arthritis?
Conservative:
Analgesia - NSAIDs, intra-articular steroids
Sulfasalazine and methotrexate for persistent disease
What is reactive arthritis associated with?
HLA B27
What is septic arthritis? Common organism?
Infection of the joint space
Red hot swollen joint, reduced range of motion
Acutelet unwell, febile child
Staphyloccous aureus
Spread haematogenously from wound, infected skin lesions, osteomyelitis
Common in under 2s
What are the Kocher criteria for diagnosing septic arthritis?
Fever > 38.5c
Non-weight bearing
Raised ESR
Raised WCC
What investigations in septic arthritis?
Blood cultures
WCC
CRP/EST
USS of deep joints
X-ray to exclude trauma
MRI if site of infection unclear
DEFINITIVE:
Synovial fluid aspiration and culture for MC&S under US guidance
What management for septic arthritis?
Synovial fluid aspiration
IV ABX flucloxacillin - clindamycin if pen allergic
6-12 weeks
Needle aspiration to decompress joint
Arthroscopic lavage
What is Juvenile Idiopathic Arthritis?
Persistent joint welling occurring in someone who is less than 16 years old that lasts for more than 6 weeks
Absence of infection or any other defined cause
What are features of systemic JIA?
Pyrexia Salmon-pink rash Lymphadenopathy Arthritis Uveitis Anorexia, weight loss
What investigations in JIA?
ANA positive
RF negative
