A Family Doctor's Tale - SEPTIC ARTHRITIS

DOC I HAVE SEPTIC ARTHRITIS

Septic Arthritis is an infection of the joint by pyogenic bacteria.

The most common causes of Septic Arthritis is

1.Staphylococcus aureus bacteria(80%).

Other bacteria involved are:

2.Streptococci Group A & B

3.Enterobacter species

4.Haemophilus influenzae

5.Pneumococci

6.Pseudomonas

Anerobic infections may also cause Septic Arthritis.

Predisposing conditions of Septic Arthritis are:
1.injury to the joint is the most common cause.

The joint injury is exposed to local infection in the skin or environment.

Staphylococcus aureus is the most common bacteria in Septic Arthritis resulting from bone injury and infection.

2.Diabetes mellitus in adults.

3.rheumatoid arthritis

4.steroid therapy

5.Joint infection in adults are usually due to their lower resistance from
a.debilitation,


b.intravenous drug abuse,


c.infectious root-canaled teeth,


d.other disease or drugs (e.g. immunosuppressive therapy).

Symptoms of Septic Arthritis:
1.pain and swelling of the joint  

Joint is hot, swollen with effusion, very tender and limited mobility

2.fever and chills

3.systemic signs of infection

Signs of Septic Arthritis:
1.Hot tender joints

2.Throbbing pain of bones in joints

3.Abscess and swelling

Diagnosis of Septic Arthritis is often based on

1.Blood ESR is raised and high polymorph leucocytes

2.Blood and joint fluid cultures are normally required to identify the specific pathogen

3.X-rays are normal at first but later show osteoporotic changes

The complications of Septic Arthritis are:

1.damage of the bones in the joint,

2.osteomyelitis

3.sepsis

Treatment of Septic Arthritis:
1.antibiotic therapy  - must be started immediately even before culture results are back and continued usually as prolonged treatment lasting a matter of weeks or months until the infection is clear.

2.Splinting or immobilization of the affected joint to prevent movement

3.Aspirations of the infected joint fluids

4.Hyperbaric oxygen therapy has helped in the treatment of refractory Septic Arthritis.

5..Septic Arthritis may also need open surgical debridement to remove pus and damaged bone tissues if infection do not respond to antibiotics.

6.Physiotherapy may be required to restore joint range and muscles once the infection has cleared up.

6.Severe cases may lead to the loss of a limb.

Prognosis of Septic Arthritis depends on the rapidity of onset of treatment.

The faster the treatment the faster the cure.

Otherwise the condition may become a chronic illness requiring multiple surgical procedures.

Prevention of Septic Arthritis is to avoid infection of the skin near the joints or injury to the joints.

Treatment of underlying conditions such as diabetes is important.