info on Septic arthritis Pls Doc Alan

[joebloggs]

Hi Doc Alan, can you give us some info on Septic arthritis :Erm:

[KeithD]

I know it needs to be treated straight away as a joint can be trashed in less than a week in most severe cases.

[joebloggs]

never heard of it til the other day, my misses thinks one of her family in the phils might have it :NoNo:

[KeithD]

Could be reactive arthritis if it's come on over night, the kind you mention is rare but curable of treated quickly with antibiotics. All my main joints are damaged thanks to arthritis, its not fun so I just ignore it :crazy: :Cuckoo:

[Doc Alan]

I'm sure you've searched the internet already, but if not, this is a good up to date link :- http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001466/
I'm not a GP, as you know, but I doubt GPs have much experience of septic arthritis as it's not common.
It should be considered in any acutely inflamed joint, as it can indeed destroy it in a day or two.
Risk factors are pre-existing joint disease, especially rheumatoid arthritis, diabetes, immunosuppression, kidney disease, and joint replacements.
Urgent joint aspiration by needle
for microscopy and culture are the key investigation. Plain X Rays can appear normal. Blood culture can help for guiding antibiotic choice later.
A key question is - how did the bug get there ? Is there another focus of infection, like pneumonia ?
If in doubt, start " empirical " ( best guess ) antibiotics until the type of bug and sensitivity is known.
An orthopaedic specialist may be needed for arthroscopy ( examination of the joint and possible biopsy for microscopy ).
Splinting and hospitalization may be needed, and ( later ) physiotherapy.
As always I'm well aware that all this may be expensive. Septic arthritis - if that's the diagnosis - is a serious condition, but treatable.