Manual Septic Bone and Joint Surgery

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Infectious arthritis is a type of arthritis that occurs when bacteria or viruses, or other organisms get into the fluid between joints and multiply.

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People are exposed to bacteria all the time, but the immune system usually removes them from the body. However, if the bacteria enter closed areas, such as the joint, they can easily multiply, causing a severe infection with inflammation and swelling. This inflammation can break down tissues in the joint, causing permanent damage of the cartilage and bone. A bacteria called Staphylococci usually causes infectious arthritis. This strain of bacteria also causes many other skin conditions. A bacterial infection usually causes infectious arthritis, but a virus or fungus can also be responsible.

Like other forms of arthritis, the primary symptoms of infectious arthritis are swelling, pain, and stiffness in the affected joints.

What to know about infectious (septic) arthritis

Other symptoms of infectious arthritis can include:. The joints most commonly affected by chronic infectious arthritis include the:. Symptoms can appear and become severe very soon after a person has contracted the infection, sometimes within a few hours. People may also experience other symptoms, depending on the organism causing the infection. In most cases, symptoms will start to improve after a 1—2 full days of treatment. A full recovery can take several weeks, but the infection should disappear entirely.

If bacteria are responsible for the infection, doctors will usually prescribe antibiotics. People should take antibiotics as early as possible to reduce the risk of permanent damage. People can take antibiotics as an oral treatment over several weeks. A full course of treatment can take up to 6—8 weeks to complete. Some people may need to spend some time in the hospital to allow continuous administration of antibiotics and to drain fluids through an IV. This treatment can last a few days or weeks, depending on the severity of the condition.

Sometimes, doctors can arrange for people to have IV antibiotics at home. Doctors may give high doses of antibiotics and may inject them to increase the speed at which they can start to take effect in the joint. If a fungus causes the infection, doctors will treat it with an antifungal medication instead of antibiotics. Infections caused by a virus do not respond to most treatments, usually clearing up themselves. However, doctors may use anti-viral medication in some cases, such as for infections caused by hepatitis B.

In some cases, doctors may need to drain fluid from the joint as it contains harmful microbes. They can do this with a syringe or by a procedure called arthroscopy. This is where a doctor inserts a small tube into the affected joint, through a small incision. People with infectious arthritis can also take other measures to help reduce symptoms and prevent long-term damage. People can try physical therapy or wearing a splint from time to time to support the affected joint. However, it is essential that a person puts their joint through range-of-motion exercises to prevent the muscles or joints from shortening.

This means they should not wear splints continuously. If people do not receive treatment early enough or a sufficient dosage, there is a risk that infectious arthritis can cause permanent damage to the tissues and bones in the joint. Without any treatment, it can also cause a severe blood infection blood called sepsis , which can be fatal. It can also lead to an infection in the bone, called osteomyelitis. How this damage impacts a person's life depends on which joints have been affected. For example, damage to a knee joint can affect a person's ability to stand or walk.

However, surgery can usually treat this type of damage. Anyone can contract infectious arthritis, but certain factors increase the risk of developing the condition, including :. To diagnose infectious arthritis, a doctor will carry out a physical examination, look at the symptoms, and discuss the person's medical history. If a doctor suspects infectious arthritis, they will recommend further tests.

Tests may include a blood test and taking a sample of fluid from the affected joint. Lab technicians will analyze the samples for signs of infection and inflammation and will culture the blood to make sure the infection has not spread further through the body. The presence of harmful microbes in the fluid or unusually high levels of white blood cells in the blood can point to infectious arthritis.

Sometimes, these tests show standard results, but infectious arthritis is still present. This is why doctors often take several sets of blood cultures. Doctors may also recommend imaging tests such as X-rays or MRI scans to assess the extent of the damage already caused by the infection.

Infectious arthritis is sometimes mistaken for a different form of arthritis called reactive arthritis. Reactive arthritis shares the same symptoms as infectious arthritis. However, infectious arthritis is caused by an active infection within the joint, while reactive arthritis usually develops as a result of an infection in another part of the body. Some people develop reactive arthritis following a sexually transmitted infection STI or an infection of the gastrointestinal tract from food poisoning. However, reactive arthritis does not usually result from the infectious organism spreading to another joint.

Instead, it occurs when the body's immune system overreacts to the infection, often causing joint inflammation elsewhere in the body. Sometimes, an infection in a joint that has cleared up some time ago can trigger the autoimmune process and lead to reactive arthritis elsewhere in the body. Infectious arthritis is a severe condition.

It may cause permanent damage to the bones and tissue surrounding the affected joint. Article last reviewed by Wed 12 September All references are available in the References tab. Infectious arthritis. Mathews, C. Bacterial septic arthritis in adults [Abstract]. Reactive arthritis. Schmitt, S. The white blood cell count of the fluid sample is typically unusually elevated. However, sometimes this can be abnormal in problems that are not an infection, such as gout or arthritis.

The most definitive test is a culture of the fluid where a pathologist grows bacteria from the fluid sample to determine exactly what is causing the infection. In addition to confirming the diagnosis of a septic joint, the culture of the fluid can help your doctor determine the best antibiotics for treatment of the condition. Septic joints require urgent treatment.

Treatment consists of draining the infection out of the joint space, often surgically, along with intravenous antibiotics. Time is essential in the treatment of an infected joint, as leaving pus inside a joint can lead to the rapid deterioration of cartilage of the joint.

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Bone and joint infections: Osteomyelitis, Septic Arthritis

This is especially concerning in young patients with otherwise healthy joints. In this setting, the risk of long-term problems is high, even with proper treatment.

Orthopedics: Septic Arthritis in Children

When an infection is treated surgically, your surgeon will either open up the joint or used instruments to enter inside the joint, circulate fluid to irrigate the joint space. It is impossible to remove every bacteria from an infected joint, but in washing out the bulk of the infection, your body has a chance to fight off the remaining infection with the aid of antibiotics. Sometimes infections are treated with open surgical debridement. This means a surgical incision is made over the joint and your surgeon will look directly inside the joint. Other times, arthroscopic joint irrigation can be performed.

In this case, an arthroscope will be inserted into the joint, and fluid can be circulated without making large incisions. Infection within the joint is a very serious problem that requires urgent treatment. Sometimes identifying an infection can be difficult, but there are laboratory tests can be performed to help determine if you have a joint infection. If a joint infection is diagnosed, typically surgery and intravenous antibiotics will be used to address the problem.

Dealing with joint pain can cause major disruptions to your day. Sign up and learn how to better take care of your body. Click below and just hit send! More in Orthopedics. A septic joint is problematic for two reasons:. The body has a hard time fighting the infection because of a lack of immune defense within the joints. Joint cartilage can be irreversibly damaged by joint infections.