Infections of the joints and bones

What is septic arthritis?

Septic arthritis is an infection in the joint fluid (also known as synovial fluid) and joint tissues. The infection usually reaches the joints though the bloodstream, although some joints may become infected after surgery or injury of an involved joint, which can expose the joint space to germs or infection.

In rare instances, an infection of the bone can spread to an adjacent joint causing septic arthritis. Bacteria, fungus, or viruses are capable of infecting the joint, although “septic arthritis” is typically used to describe non-viral causes of joint infections, which are usually caused by bacteria.

In most children, septic arthritis only affects one joint in the body. The most common sites for septic arthritis include the:

  • Knee
  • Hip
  • Ankle
  • Elbow
  • Wrist
  • Shoulder
  • Pelvis

Causes

Many different types of bacteria can cause septic arthritis. The type of bacteria depends on the site of infection, age of the patient, and any underlying medical conditions that may make a child more likely to acquire a joint infection.

Bacteria most often associated with septic arthritis include, but are not limited to:

  • Staphylococci
  • Haemophilus influenzae
  • Gram-negative bacilli
  • Streptococci

These bacteria can enter a child’s body in a variety of ways, including:

  • Infection that spreads from another source inside the body, such as a skin or bone infection adjacent to a joint
  • Infected wounds
  • Open fractures, or bones that penetrate through the skin
  • Foreign object penetrating the skin
  • Trauma

Signs and symptoms

Symptoms of septic arthritis vary from child to child and may differ depending on which joint is affected, the age of the child, and the type of organism causing the infection.

Septic arthritis typically has a fast onset with symptoms progressing to the point of severe pain and immobility of the affected joint within hours.

Common symptoms include:

  • Joint pain, usually severe
  • Joint swelling
  • Redness in the area of the affected joint
  • Warmth around the affected joint
  • Limping
  • Refusal to walk or bear weight on the affected joint
  • Limited use of the affected joint
  • Guarding or protecting the affected joint to prevent it from being touched or moved
  • Other symptoms of illness, such as fever, vomiting, sore throat or headache

Treatment

Specific treatment for septic arthritis will be determined by your child’s doctor based on:

  • Your child’s overall health and medical history
  • The type of bacteria causing the infection, location of infection, and predisposing medical conditions
  • Your child’s tolerance for specific medications, procedures, and therapies
  • Expectation for the course of the disease
  • Your opinion or preference

Septic arthritis usually requires treatment with antibiotics, which are often given intravenously to ensure prompt response to therapy. Antibiotics are only effective if your child’s condition is caused by a bacteria.

If your child’s infection is caused by fungi, he will need antifungal medications.

If a viral infection caused your child’s septic arthritis, the virus will usually need to run its course without treatment, although medications can be used to help alleviate pain.

In some cases, the infected joint must be drained and cleaned because antibiotics cannot penetrate deep enough into a severely infected joint. This may require drainage by a needle, tube or surgery.

Other symptom-based treatments may include:

  • Medications for pain and fever
  • Physical therapy to maintain muscle strength and joint range of motion
  • Splinting the joint to relieve pain

Pre-OP & Post-OP Pictures

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