This is an acute infection of the joint space.
- Haematogenous spread from a primary focus elsewhere in the body.
- Directing penetrating injuries onto the joint.
- Extension of infection from a compound fracture of the neighbouring bone.
- The commonest causative organisms are staphylococcus aureus, streptococcus pyogenes, and haemophilus influenzae, and to a lesser extent salmonella typhimurium or typhy.
- large joints such as shoulder, knee, ankle, and hip are more often affected
- Septic arthritis is the most common in children under 3 years of age.
- Fever, chills and irritability
- Swollen, warm, very tender joint(s)
- Pseudoparalysis of the joint
- Multiple joints may be affected
- Haemogram-Anaemia and leukocytosis present
- Pus for culture and sensitivity
- Radiograph of the affected joint shows increased joint space, synovial thickening, and later rarefaction of the adjacent bone surfaces.
- Admit the patient
- Take pus sample for culture and sensitivity.
- Start on antibiotics: Flucloxacillin 5o-100mg/kg 6 IV hourly. Change according to culture and sensitivity results and continue for a period of 4-6 weeks
- Splint the joint and initiate physiotherapy.
- Give analgesics and antipyretics: tabs ibuprofen 400mg orally 8 hourly OR aspirin 600mg orally 8 hourly for 3 days.
- Aspirate the joint: if there is frank pus then form an arthrotomy. Review daily until drainage.
- Review monthly after discharge.
- Watch for features of a worsening condition, which include the following:
- The fever persists for more than 7 days of full treatment.
- The joint swelling does not subside within 3 weeks.
- New joints get involved while on treatment.
- As much as possible, refer the patient to an appropriate facility before the following complications have developed, or refer immediately if they present with any of these complications:
- The affected joint starts to discharge pus spontaneously.
- Shortening of the limb occurs.
- There is a persistent deformity of the joint.
- There is loss of function related to the infection.