
Septic Knee Arthritis, Caused by Tuberculosis: Lynn MM, 2012. Rheumatology Department, Queen Elisabeth Hospital, London, UK. CC BY 2.0
Contents
Definition
Septic arthritis is inflammation of the joints (Arthritis) caused by bacteria or other microorganisms. Infections of the vertebrae are termed Pyogen vertebral osteomyelitis.
Disease Cause
The most common thing about septic arthritis is that bacteria spread through the blood from another infection and migrate from the blood into one (less frequently more) joint. The Rarer requires bacteria from the skin, wounds or stings.
- Risk Factors
- Age over 65 years
- Diabetes mellitus (diabetes)
- Other rheumatic disease (at Arthritis, RA is the risk 4-15 doubled)
- Skin infection
- Intravenous substance abuse
- venous Catheters
- Liver disease
- Surgical intervention
- The most common cause is the bacterium Staphylococcus aureus (S. aureus) in Europe. Staphylococci have their own ability to infect joints. They can form one biofilm in the infected joint, making it difficult to get rid of the infection
- Rarer bacteria
- Streptococcus
- gonorrhea
- Lyme disease (after bite of ticks)
- Tuberkulosis (Tbc)
- Often little pain
- Large joint injury (X-ray examination)
Occurrence
The rate of septic arthritis (prevalence) is estimated at 4-10 / 100.000 in Western Europe (reference: Mathews CJ, 2010)
Symptoms
Knees are most commonly attacked (more than 50% of cases).
- Hips, ankles, wrists are less frequently attacked
- Pain, increased joint heat and swelling usually occur within a few hours and precede cartilage and bone damage
Diagnosis
In about 50% the growth of bacteria in the blood is detected. Joint fluid and blood samples for the detection of bacteria are essential and should be sought before antibiotics are given.
Treatment
Antibiotics, intravenously
- Often the affected joint must be rinsed and drained repeatedly. This is usually done in the orthopedic department.
Incorrect diagnosis, Similar conditions, Differential diagnoses
Guidelines / recommendations
EULAR 2016 (Combe B, Management early arthritis)
ACR 2017 (Ringhold S, 2017; JIA and tuberculosis)
International 2014 (Inanone F, 2014)
Norwegian Rheumatological Association
Literature
- Septic arthritis in children (reference: Donnan L, 2015)
- Wikipedia
- Grans Compendium in Rheumatology
- Great Norwegian encyclopedia
More about Arthritis here (in Danish) (Bindevevssykdommer.no)