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Terms in this set (19)
What are the two most common causes of septic arthritis?
- S. aureus
- N. gonorrhea
Where is acute bacterial arthritis usually found in general?
- typically involves a single joint
- very destructive to articular cartilages
Where is septic arthritis found in infants? Etiological Agent?
- S. agalactiae
Where is septic arthritis found in children? Etiological Agents?
less than 2: H. influenzae, S. aureus and K. kingae
over 2: S. aureus and S. pyogenes
Where is septic arthritis found in sexually active and not, adults? Etiological Agent?
- N. gonorrhoae (active)
- S. aureus (not active)
Where is septic arthritis found in IV drug users?
- sternoclavicular and sacroiliac joints
Who is predisposed to septic arthritis?
- patients with rheumatic arthritis
- glucocorticoid therapy
How does septic arthritis present?
- uniform pain around the joint
- effusion, muscle spasm, decreased ROM
- fever (except in RA patients)
- swollen joint (except in shoulder, sacroiliac or hip joint)
- PAINFUL ROM
How is septic arthritis distinguished from osteomyelitis?
Septic arthritis: PAINFUL ROM
Osteomyelitis: less pain on active motion of the joint
Disseminated gonococcal infection is more in common in what gender? Why?
- women (mostly during pregnancy or after menstruation)
- Alkaline vaginal pH makes organisms more resistant to host defenses, thus, N. gonorrheae is more likely to disseminate
Describe Gonococcal Polyarthritis
- dermatitis-arthritis syndrome
- migratory polyarthritis, tenosynovitis and dermatitis
- papules progress to hemorrhagic pustules
- lesions and articular finding due to host's immune reaction to circulating gonococci
How is gonococcal polyarthritis diagnosed?
- culture of synovial fluid is usually negative
- BLOOD culture is positive 50% of time
- sample from mucosal sites immediately onto Thayer Martin
How is gonococcal Septic arthritis diagnosed?
- synovial fluid culture (45% positive)
- blood culture is almost always negative
How is non-gonococcal septic arthritis diagnosed?
- blood culture
- aspirate synovial fluid from knee
--> purulent, gram stain will show organisms and PMNs
Describe the synovial fluid of septic arthritis
- purulent, yellow to green, variably viscous
- 25,000-100,000 WBC
- 75% PMNs
Lyme Arthritis. Cause and Location? How to Dx?
- Boriella bugdorferi
- commonly in knees
- can persist even with correct Tx
- Dx with serum antibody titers
Describe syphilitic arthritis (early vs. late)
- osteochondritis of long bones (early congenital syphilis)
- chronic painless synovitis (late congenital syphilis)
septic arthritis with prosthetic joints within 6 months of surgery, what is the cause?
S. aureus (acute form)
septic arthritis with prosthetic joints 6-24 months after surgery, what is the cause?
S. epidermidis (chronic form)
THIS SET IS OFTEN IN FOLDERS WITH...
IDIS: SA with pictures
IDIS: OM with pictures
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