Three mechanisms can lead to septic arthritis: (1) hematogenous spread of bacteria, (2) migration of bacteria from a focus contiguous to a joint, and (3) direct inoculation of bacteria into the joint.
Septic arthritis is a medical emergency. A rampant bacterial infection with a normal inflammatory response can destroy a joint within hours to days. The involved joint can become exquisitely painful over a few hours. On examination, effusions may be scant, with significant splinting and resistance to movement.
Although the classic bacterial arthritis patient is described as febrile with chills and rigors, a 10-year retrospective review of 43 adult patients noted presence of fever or rigors in only 40 and 21 percent of patients, respectively.10 Thus, the absence of constitutional symptoms should not preclude a septic arthritis diagnosis. A suspicion for a bacterial infection should always guide clinical decision making when approaching patients with monoarthritis.
After joint aspiration, if septic arthritis cannot be excluded, the patient should be admitted for pain control and parenteral antibiotics until synovial culture results are available. Consultation with the orthopedics or infectious disease departments is desirable. Repeat closed needle aspiration, arthroscopy, or open surgical drainage may be required, depending on a number of factors, including consultant preference, patient age, affected joint, and likelihood of septic source.
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Thank you for deciding to learn more about the disorder, Osteoarthritis. Inside these pages, you will learn what it is, who is most at risk for developing it, what causes it, and some treatment plans to help those that do have it feel better. While there is no definitive “cure” for Osteoarthritis, there are ways in which individuals can improve their quality of life and change the discomfort level to one that can be tolerated on a daily basis.