| Septic arthritis | |
|---|---|
| Other names | Infectious arthritis, joint infection |
.jpg) | |
| Septic arthritis as seen during arthroscopy[1] The arrow points to debris in the joint space. | |
| Specialty | Orthopedic surgery |
| Symptoms | Red, hot, painful single joint[2] |
| Usual onset | Rapid[2] |
| Causes | Bacteria, viruses, fungi, parasites[3] |
| Risk factors | Artificial joint, prior arthritis, diabetes, poor immune function[2] |
| Diagnostic method | Joint aspiration with culture[2] |
| Differential diagnosis | Rheumatoid arthritis, reactive arthritis, osteoarthritis, gout[2][3] |
| Treatment | Antibiotics, surgery[2] |
| Medication | Vancomycin, ceftriaxone, ceftazidime[2] |
| Prognosis | 15% risk of death (treatment), 66% risk of death (without treatment)[2] |
| Frequency | 5 per 100,000 per year[3] |
Acute septic arthritis, infectious arthritis, suppurative arthritis, pyogenic arthritis,[4] osteomyelitis, or joint infection is the invasion of a joint by an infectious agent resulting in joint inflammation. Generally speaking, symptoms typically include redness, heat and pain in a single joint associated with a decreased ability to move the joint. Onset is usually rapid. Other symptoms may include fever, weakness and headache. Occasionally, more than one joint may be involved, especially in neonates, younger children and immunocompromised individuals.[2][3][5] In neonates, infants during the first year of life, and toddlers, the signs and symptoms of septic arthritis can be deceptive and mimic other infectious and non-infectious disorders.[5]
In children, septic arthritis is usually caused by non-specific bacterial infection and commonly hematogenous, i.e., spread through the bloodstream.[6][7] Septic arthritis and/or acute hematogenous osteomyelitis usually occurs in children with no co-occurring health problems. Other routes of infection include direct trauma and spread from a nearby abscess. Other less common cause include specific bacteria as mycobacterium tuberculosis, viruses, fungi and parasites.[3] In children, however, there are certain groups that are specifically vulnerable to such infections, namely preterm infants, neonates in general, children and adolescents with hematologic disorders, renal osteodystrophy, and immune-compromised status. In adults, vulnerable groups include those with an artificial joint, prior arthritis, diabetes and poor immune function.[2] Diagnosis is generally based on accurate correlation between history-taking and clinical examination findings, and basic laboratory and imaging findings like joint ultrasound.[5]
In children, septic arthritis can have serious consequences if not treated appropriately and timely. Initial treatment typically includes antibiotics such as vancomycin, ceftriaxone or ceftazidime.[2] Surgery in the form of joint drainage is the gold standard management in large joints like the hip and shoulder.[2][5][8] Without early treatment, long-term joint problems may occur, such as irreversible joint destruction and dislocation.[2]
- ^ Hagino T, Wako M, Ochiai S (1 October 2011). "Arthroscopic washout of the ankle for septic arthritis in a three-month-old boy". Sports Medicine, Arthroscopy, Rehabilitation, Therapy & Technology. 3 (1): 21. doi:10.1186/1758-2555-3-21. PMC 3192658. PMID 21961455.
- ^ a b c d e f g h i j k l m Horowitz DL, Katzap E, Horowitz S, Barilla-LaBarca ML (15 September 2011). "Approach to septic arthritis". American Family Physician. 84 (6): 653–660. PMID 21916390.
- ^ a b c d e "Arthritis, Infectious". NORD (National Organization for Rare Disorders). 2009. Archived from the original on 21 February 2017. Retrieved 19 July 2017.
- ^ "A to Z: Pyogenic Arthritis (Septic Arthritis)". www.hopkinsallchildrens.org. Johns Hopkins All Children’s Hospital. Retrieved 9 June 2023.
- ^ a b c d El-Sobky T, Mahmoud S (July 2021). "Acute osteoarticular infections in children are frequently forgotten multidiscipline emergencies: beyond the technical skills". EFORT Open Reviews. 6 (7): 584–592. doi:10.1302/2058-5241.6.200155. ISSN 2396-7544. PMC 8335954. PMID 34377550.
- ^ Thévenin-Lemoine C, Vial J, Labbé JL, Lepage B, Ilharreborde B, Accadbled F (2016-11-01). "MRI of acute osteomyelitis in long bones of children: Pathophysiology study". Orthopaedics & Traumatology: Surgery & Research. 102 (7): 831–837. doi:10.1016/j.otsr.2016.06.014. ISSN 1877-0568. PMID 27641643.
- ^ Zairi M, Mohseni AA, Msakni A, Jaber C, Mensia K, Saied W, Bouchoucha S, Boussetta R, Nessib MN (2022-10-01). "Acute hematogenous osteomyelitis in children: Management of pandiaphysitis with extensive bone destruction: A case series of thirteen child". Annals of Medicine and Surgery. 82: 104578. doi:10.1016/j.amsu.2022.104578. ISSN 2049-0801. PMC 9577533. PMID 36268342. S2CID 252175786.
- ^ Swarup I, LaValva S, Shah R, Sankar WN (February 2020). "Septic Arthritis of the Hip in Children: A Critical Analysis Review". JBJS Reviews. 8 (2): e0103. doi:10.2106/JBJS.RVW.19.00103. PMID 32224630. S2CID 214731307.