Septic arthritis

Overview

Septic arthritis can be a painful condition in the joints that is caused by germs that have traveled through your bloodstream to another part of your body. A penetrating injury such as a bite or trauma to an animal can also cause septic arthritis.

Septic arthritis is more common in infants than in older adults. Septic arthritis is also possible in people with artificial joints. Most commonly, septic arthritis affects the knees. However, it can also affect hips and shoulders, as well as other joints. It is important to get treatment immediately as the infection can cause severe damage to the cartilage and bone of the joint.

The procedure involves either removing the joint using a needle or performing surgery. Antibiotics are often prescribed.

Signs

Septic arthritis can cause extreme pain and make it difficult to use the affected joint. You might feel swollen, red, or warm in the affected joint.

Septic arthritis (prosthetic joint infection) can develop in an artificial joint. Signs and symptoms like minor pain and swelling could appear months to years after a knee replacement or hip replacement. A loosening of the joints can cause pain when moving or putting weight onto the joint. The pain usually goes away after a rest. Extreme cases may result in the dislocation of the joint.

When should you see a doctor?

If you experience severe pain in your joint, consult your doctor immediately. Joint damage can be minimized if you get treatment quickly.

If you feel pain when using an artificial joint, consult your doctor.

Causes

Septic arthritis can result from fungal, viral, or bacterial infections. The most common cause is a bacterial infection with Staphylococcus Aureus (staph). Staph can live on healthy skin.

When an infection spreads from your bloodstream to a particular joint, it can lead to severe arthritis. A puncture wound, drug injection or surgery near a joint, including joint replacement surgery, can allow germs to enter the joint space.

Your joints’ lining is unable to defend itself against infection. The damage is caused by your body’s response to infection. This includes inflammation, which can cause swelling and increase pressure within the joint.

Risk factors

Septic arthritis is a condition that can be caused by the following risk factors:

  • Existing joint problems.Your risk of developing septic arthritis can be increased by chronic conditions and conditions that affect your joints, such as osteoarthritis or rheumatoidarthritis or lupus. Previous joint surgery, and injury can also increase your chances.
  • Artificial jointsJoint replacement surgery can introduce bacteria. An artificial joint could also become infected if germs are carried through the bloodstream from another area of the body.
  • Take medication for rheumatoid arthritis.Rheumatoid arthritis sufferers are at greater risk due to the fact that they may be taking medications that suppress their immune system. This can make infections more likely. Because many symptoms and signs are the same, it can be difficult to diagnose septic arthritis in people suffering from rheumatoid.
  • Skin fragilityIf your skin breaks easily or heals poorly, bacteria can gain access to your body. As well as skin conditions like eczema and psoriasis, infected wounds and skin conditions can increase the risk of developing septic arthritis. Regular injectors of drugs are at greater risk for infection.
  • Weak immune system.Septic arthritis is more common in those with weaker immune systems. People with kidney, liver, or diabetes are at greater risk.
  • Joint trauma.Septic arthritis can be caused by animal bites, puncture wounds, or cuts to the joints.

A combination of risk factors can put you at greater risk than if you have just one.

Complications

Septic arthritis can cause joint degeneration and permanent injury if it is not treated promptly. Septic arthritis can cause dislocation or joint loosening in artificial joints.

Diagnosis

These tests are often used to diagnose septic arthritis.

  • Joint fluid analysis.Infections can change the consistency, color, volume, and makeup of the fluid in your joints. You can take a sample of the fluid from affected joints with a needle. Your doctor can perform laboratory tests to determine the organism that is causing your infection.
  • Blood tests.These tests can detect if your blood is contaminated. With a needle, a sample of your blood can be taken from a vein.
  • Imaging testsThe affected joint can be assessed by X-rays or other imaging tests.

If your doctor suspects that you have a prothetic joint infection, he or she may use a specialized scan. This involves injecting small amounts of radioactive chemicals into the area.

Treatment

To treat septic arthritis, doctors rely on joint drainage and antibiotics.

Joint drainage

It is essential to drain the infected fluid from the joints. These are some of the drainage options:

  • Needle.Your doctor may be able to drain the fluid using a needle that is inserted into the joint.
  • Scope procedure.A flexible tube with a camera at the tip of it is used in arthroscopy (pronounced “ahr-THROS”-kuh-pee). It is inserted into your joint via a small incision. Through small incisions, drainage and suction tubes can be inserted into your joint.
  • Open surgery.Some joints, like the hip, can be more difficult to drain using arthroscopy or a needle. Therefore, an open surgery might be required.

Antibiotics

Your doctor will need to identify the source of your infection in order to prescribe the best medication. At first, antibiotics are administered through an arm vein. You may later be able switch to oral antibiotics.

Treatment typically lasts between two and six weeks. Side effects of antibiotics include nausea, vomiting, and diarrhea. Allergy reactions can also occur. Ask your doctor about side effects of your medication.

Removing the replacement joint

Treatment for an infected artificial joint involves the removal of the joint and temporary replacement with a joint spacer, which is a device with antibiotic cement. A new replacement joint will be installed several months later.

A doctor can clean the joint, remove any damaged tissue and place the replacement joint. To prevent the infection from returning, intravenous antibiotics should be followed up with oral antibiotics over several months.

Prepare for your appointment

Your family doctor is the best place to begin if you have inflamed or painful joints. Your family doctor may refer you to an orthopedic surgeon or infectious disease specialist, or a joint specialist (rheumatologist).

These are some tips to help you prepare for your appointment.

What you can do

Ask the receptionist if there are any preparations you should make, such as fasting to take certain tests. You can make a list of:

  • Your symptomsInclude any other information that might be unrelated to the purpose for which you have scheduled the appointment
  • Personal information that is importantInclude any medical conditions and recent infections.
  • MedicinesYou take vitamins or supplements, and the dosages
  • Questions to ask your doctor

If possible, bring a friend or family member along to help you remember the information you have been given.

Ask your doctor questions about septic arthritis.

  • What could be causing my symptoms?
  • Do you think there are other causes?
  • What are the tests I need?
  • Are my symptoms likely to be temporary or permanent?
  • Which is the best course?
  • Is there another approach?
  • What is the best time to expect that my symptoms will improve after treatment?
  • What can I do to relieve my joint pain while I wait?
  • Are there any long-term complications?
  • How can I manage this condition in conjunction with other health issues?
  • Do I need to see a specialist?
  • Do you have brochures or any other printed material I can use? Which websites would you recommend?

Ask any questions you may have.

What to expect from your doctor

You may be asked questions by your doctor, including:

  • When did your symptoms begin?
  • Are your symptoms ongoing or intermittent?
  • What are your symptoms?
  • What can you do to help your symptoms?
  • Are you experiencing symptoms that are worsening?
  • Are you a candidate for joint surgery?
  • Are you a recreational drug user?
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