Acute suppurative arthritis; septic arthritis serious infection of a joint caused by bacteria

Описание: Acute suppurative arthritis (also called septic arthritis) is a serious infection of a joint caused by pyogenic (pus-forming) bacteria. It is a medical emergency because it can rapidly destroy the joint if not treated promptly.

Causes
Common organisms:

Staphylococcus aureus (most frequent cause in all age groups).

Streptococcus species.

Gram-negative bacilli (especially in elderly, immunocompromised, or IV drug users).

Neisseria gonorrhoeae (important cause in young adults).

Routes of infection:

Hematogenous spread (most common).

Direct inoculation (trauma, surgery, intra-articular injection).

Spread from adjacent osteomyelitis or soft tissue infection.

Pathophysiology
Bacteria invade the synovial membrane → intense inflammatory response.

Pus accumulates in the joint cavity → increased intra-articular pressure.

Rapid destruction of articular cartilage → permanent joint damage if untreated.

Clinical Features
Acute onset of severe joint pain, swelling, warmth, and redness.

Restricted movement due to pain.

Systemic symptoms: fever, malaise, leukocytosis.

Common sites: knee (most frequent), hip, shoulder, ankle, wrist.

Diagnosis
Clinical suspicion is key (painful swollen joint + fever).

Joint aspiration (arthrocentesis):

Purulent fluid.

Gram stain and culture confirm organism.

Laboratory tests: elevated WBC, ESR, CRP.

Imaging: X-ray may be normal early; ultrasound detects effusion; MRI useful for deep joints.

Management
Emergency treatment to prevent irreversible joint damage.

Joint drainage:

Needle aspiration, arthroscopic lavage, or open surgical drainage.

Antibiotics:

Empirical IV antibiotics started immediately, tailored to culture results.

Duration: usually 4–6 weeks.

Supportive care:

Analgesics, immobilization initially, followed by physiotherapy to restore function.

Complications
Rapid cartilage destruction → permanent arthritis.

Osteomyelitis (spread to bone).

Septicemia.



#Arthritis