Septic arthritis Arthritis Acute or chronic inflammation of joints. Osteoarthritis is an infection of the joint due to direct inoculation, contiguous extension Extension Examination of the Upper Limbs, or hematogenous Hematogenous Hepatocellular Carcinoma (HCC) and Liver Metastases spread of infectious Infectious Febrile Infant organisms into the joint space. This process causes an acute, inflammatory, monoarticular arthritis Arthritis Acute or chronic inflammation of joints. Osteoarthritis. A variety of organisms have been implicated, most commonly Staphylococcus Staphylococcus Staphylococcus is a medically important genera of Gram-positive, aerobic cocci. These bacteria form clusters resembling grapes on culture plates. Staphylococci are ubiquitous for humans, and many strains compose the normal skin flora. Staphylococcus aureus. Previously damaged joints (e.g., rheumatoid arthritis Rheumatoid arthritis Rheumatoid arthritis (RA) is a symmetric, inflammatory polyarthritis and chronic, progressive, autoimmune disorder. Presentation occurs most commonly in middle-aged women with joint swelling, pain, and morning stiffness (often in the hands). Rheumatoid Arthritis) are at the highest risk of infection. Patients Patients Individuals participating in the health care system for the purpose of receiving therapeutic, diagnostic, or preventive procedures. Clinician–Patient Relationship present with a swollen, warm, and tender joint, most commonly involving the knee. Positive cultures Cultures Klebsiella from arthrocentesis are diagnostic, with antibiotic therapy tailored to the specific organism. Repeated joint aspiration, or surgical drainage, is required in some cases. If the joint space is infected with a prosthetic in place, debridement Debridement The removal of foreign material and devitalized or contaminated tissue from or adjacent to a traumatic or infected lesion until surrounding healthy tissue is exposed. Stevens-Johnson Syndrome and prosthesis removal may also be required.
Last updated: 15 Mar, 2021
The majority of septic arthritis Arthritis Acute or chronic inflammation of joints. Osteoarthritis infections Infections Invasion of the host organism by microorganisms or their toxins or by parasites that can cause pathological conditions or diseases. Chronic Granulomatous Disease are monomicrobial. Common organisms include:
Risk factors | Infectious Infectious Febrile Infant agents |
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No specific risk factor | S. aureus S. aureus Potentially pathogenic bacteria found in nasal membranes, skin, hair follicles, and perineum of warm-blooded animals. They may cause a wide range of infections and intoxications. Staphylococcus |
Prosthetic joint replacement |
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Chronic disease, autoimmune disorder, skin Skin The skin, also referred to as the integumentary system, is the largest organ of the body. The skin is primarily composed of the epidermis (outer layer) and dermis (deep layer). The epidermis is primarily composed of keratinocytes that undergo rapid turnover, while the dermis contains dense layers of connective tissue. Skin: Structure and Functions infection, trauma, elderly | S. pyogenes (group A beta-hemolytic strep) |
Young, sexually active | N. gonorrhoeae N. gonorrhoeae A species of gram-negative, aerobic bacteria primarily found in purulent venereal discharges. It is the causative agent of gonorrhea. Neisseria |
Trauma | S. epidermidis S. epidermidis A species of staphylococcus that is a spherical, non-motile, gram-positive, chemoorganotrophic, facultative anaerobe. Mainly found on the skin and mucous membrane of warm-blooded animals, it can be primary pathogen or secondary invader. Staphylococcus |
Sickle cell anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types |
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Knee swelling Swelling Inflammation and mild erythema Erythema Redness of the skin produced by congestion of the capillaries. This condition may result from a variety of disease processes. Chalazion in a patient with septic arthritis Arthritis Acute or chronic inflammation of joints. Osteoarthritis
Image: “Troublesome Tuberculosis Tuberculosis Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis complex bacteria. The bacteria usually attack the lungs but can also damage other parts of the body. Approximately 30% of people around the world are infected with this pathogen, with the majority harboring a latent infection. Tuberculosis spreads through the air when a person with active pulmonary infection coughs or sneezes. Tuberculosis: A Case Report on Multi-focal Tuberculous Osteomyelitis Osteomyelitis Osteomyelitis is an infection of the bone that results from the spread of microorganisms from the blood (hematogenous), nearby infected tissue, or open wounds (non-hematogenous). Infections are most commonly caused by Staphylococcus aureus. Osteomyelitis in An Immunocompetent Patient” by Lynn MM MM Multiple myeloma (MM) is a malignant condition of plasma cells (activated B lymphocytes) primarily seen in the elderly. Monoclonal proliferation of plasma cells results in cytokine-driven osteoclastic activity and excessive secretion of IgG antibodies. Multiple Myeloma, Kukanesen JR, Khan AW. License: CC BY 2.0Significant erythema Erythema Redness of the skin produced by congestion of the capillaries. This condition may result from a variety of disease processes. Chalazion and swelling Swelling Inflammation over the right sternoclavicular joint Sternoclavicular Joint Examination of the Upper Limbs, which is concerning for septic arthritis Arthritis Acute or chronic inflammation of joints. Osteoarthritis
Image: “ Sternoclavicular joint Sternoclavicular Joint Examination of the Upper Limbs septic arthritis Arthritis Acute or chronic inflammation of joints. Osteoarthritis with chest wall Chest wall The chest wall consists of skin, fat, muscles, bones, and cartilage. The bony structure of the chest wall is composed of the ribs, sternum, and thoracic vertebrae. The chest wall serves as armor for the vital intrathoracic organs and provides the stability necessary for the movement of the shoulders and arms. Chest Wall: Anatomy abscess Abscess Accumulation of purulent material in tissues, organs, or circumscribed spaces, usually associated with signs of infection. Chronic Granulomatous Disease in a healthy adult: a case report” by Tanaka Y, Kato H, Shirai K, Nakajima Y, Yamada N, Okada H, Yoshida T, Toyoda I, Ogura S. License: CC BY 4.0The diagnosis of septic arthritis Arthritis Acute or chronic inflammation of joints. Osteoarthritis is made with synovial fluid analysis Synovial Fluid Analysis Rheumatoid Arthritis.
Laboratory studies that support the diagnosis:
X-ray X-ray Penetrating electromagnetic radiation emitted when the inner orbital electrons of an atom are excited and release radiant energy. X-ray wavelengths range from 1 pm to 10 nm. Hard x-rays are the higher energy, shorter wavelength x-rays. Soft x-rays or grenz rays are less energetic and longer in wavelength. The short wavelength end of the x-ray spectrum overlaps the gamma rays wavelength range. The distinction between gamma rays and x-rays is based on their radiation source. Pulmonary Function Tests showing soft-tissue swelling Swelling Inflammation of the right ankle in an 8-month-old patient with septic arthritis Arthritis Acute or chronic inflammation of joints. Osteoarthritis
Image: “Polyarticular Septic Arthritis Arthritis Acute or chronic inflammation of joints. Osteoarthritis Caused by Haemophilus influenzae Haemophilus Influenzae A species of Haemophilus found on the mucous membranes of humans and a variety of animals. The species is further divided into biotypes I through viii. Haemophilus Serotype f in an 8-Month-Old Immunocompetent Infant: A Case Report and Review of the Literature” by Ali RA, Kaplan SL, Rosenfeld SB. License: CC BY 3.0MRI showing a large effusion between the humerus Humerus Bone in humans and primates extending from the shoulder joint to the elbow joint. Arm: Anatomy and olecranon Olecranon A prominent projection of the ulna that articulates with the humerus and forms the outer protuberance of the elbow joint. Arm: Anatomy process in a pediatric patient with septic arthritis Arthritis Acute or chronic inflammation of joints. Osteoarthritis
Image: “Polyarticular Septic Arthritis Arthritis Acute or chronic inflammation of joints. Osteoarthritis Caused by Haemophilus influenzae Haemophilus Influenzae A species of Haemophilus found on the mucous membranes of humans and a variety of animals. The species is further divided into biotypes I through viii. Haemophilus Serotype f in an 8-Month-Old Immunocompetent Infant: A Case Report and Review of the Literature” by Ali RA, Kaplan SL, Rosenfeld SB. License: CC BY 3.0X-ray X-ray Penetrating electromagnetic radiation emitted when the inner orbital electrons of an atom are excited and release radiant energy. X-ray wavelengths range from 1 pm to 10 nm. Hard x-rays are the higher energy, shorter wavelength x-rays. Soft x-rays or grenz rays are less energetic and longer in wavelength. The short wavelength end of the x-ray spectrum overlaps the gamma rays wavelength range. The distinction between gamma rays and x-rays is based on their radiation source. Pulmonary Function Tests of the knee demonstrating mild periarticular osteopenia Osteopenia Osteoporosis and significant joint-space narrowing in a patient with septic arthritis Arthritis Acute or chronic inflammation of joints. Osteoarthritis
Image: “Disseminated Aspergillus Aspergillus A genus of mitosporic fungi containing about 100 species and eleven different teleomorphs in the family trichocomaceae. Echinocandins flavus following septic arthritis Arthritis Acute or chronic inflammation of joints. Osteoarthritis in an immunocompetent patient: a case report” by Tiwari V, Khatri K, Khan SA, Nath D. License: CC BY 4.0Ultrasound of the right shoulder glenohumeral articulation showing a distended posterior aspect of joint capsule Joint capsule The sac enclosing a joint. It is composed of an outer fibrous articular capsule and an inner synovial membrane. Hip Joint: Anatomy by fluid (A) in a patient with septic arthritis Arthritis Acute or chronic inflammation of joints. Osteoarthritis
Image: “ Streptococcus Streptococcus Streptococcus is one of the two medically important genera of gram-positive cocci, the other being Staphylococcus. Streptococci are identified as different species on blood agar on the basis of their hemolytic pattern and sensitivity to optochin and bacitracin. There are many pathogenic species of streptococci, including S. pyogenes, S. agalactiae, S. pneumoniae, and the viridans streptococci. Streptococcus agalactiae Septic Arthritis Arthritis Acute or chronic inflammation of joints. Osteoarthritis of the Shoulder and the Sacroiliac Joints: A Case Report” by Imam YZ, Sarakbi HA HA Hemolytic anemia (HA) is the term given to a large group of anemias that are caused by the premature destruction/hemolysis of circulating red blood cells (RBCs). Hemolysis can occur within (intravascular hemolysis) or outside the blood vessels (extravascular hemolysis). Hemolytic Anemia, Abdelwahab N, Mattar I. License: CC BY 3.0Antibiotic selection Selection Lymphocyte activation by a specific antigen thus triggering clonal expansion of lymphocytes already capable of mounting an immune response to the antigen. B cells: Types and Functions is based on the initial Gram stain Gram stain Klebsiella and tailored based on culture data.
Duration of therapy depends on additional factors:
Joint drainage:
Surgical debridement Debridement The removal of foreign material and devitalized or contaminated tissue from or adjacent to a traumatic or infected lesion until surrounding healthy tissue is exposed. Stevens-Johnson Syndrome in patients Patients Individuals participating in the health care system for the purpose of receiving therapeutic, diagnostic, or preventive procedures. Clinician–Patient Relationship with prosthesis: