Septic arthritis is a condition in which a joint and the synovial fluid surrounding it get infected causing a painful condition for which immediate treatment should be sought. Its onset is sudden and it usually affects children and older adults.
- The result of bacterial, viral or fungal infection, the way the causative factor enters the body varies.
- Staphylococcus aureus is the bacteria that is most commonly responsible for the condition.
- Other than this, the HIV virus, Streptococci, Gonococci, etc. can also cause septic arthritis.
There are several ways by which the bacteria can enter the body.
- An open fracture where the bone is exposed might act as an entry point for the bacteria.
- A bacterial skin infection could also spread to the bones causing septic arthritis. The same goes for genital infections as well.
- When an injury in another part of the body gets infected, the infection might spread to the bones.
- A deep cut in the skin or some external object entering the body (as in the case of a road traffic accident) are the other ways by which bacteria can enter the body.
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While anyone can develop septic arthritis, it is more common among people with the following conditions:
- People who are already afflicted with other joint issues like osteoarthritis, lupus, etc. are more susceptible to septic arthritis.
- People who have undergone joint replacement surgeries are also more at risk. This is because bacteria can gain entry into the joint during surgery or alternatively, the artificial joint (prosthesis) can get affected by an infection in another part of the body.
- People with rheumatoid arthritis might be placed on immuno-suppressants. As a result, they are more prone to septic arthritis as their immunity is lowered.
- When people have skin conditions like psoriasis, their skin might dry up and break open making it possible for bacteria to enter the body.
- Frequent intravenous drug use can also cause septic arthritis.
- Alcohol addiction too heightens the risk.
- People with diabetes lung infections and liver disorders are also more at greater risk
- Being bitten by animals or having an injury very close to a joint are other risk factors.
- Having more than one of the aforementioned risk factors further increases the threat of infection.
Septic arthritis can worsen very quickly and cause irreversible damage to the joint, hence timely treatment is of the essence. The common symptoms include:
- Pain, inflammation and resistance felt while moving the joint, are common indicators of the condition.
- This might be accompanied by fever and tiredness.
- The pain felt with septic arthritis is more severe than normal arthritis.
Consult a doctor immediately if the onset of pain is sudden and severe. In the case of people who have undergone joint replacement, any joint pain in the prosthetic warrants a check-up.
- The doctor will conduct a detailed physical examination and will also review the person’s medical history.
- This will be followed by blood tests to check for bacterial presence.
- The synovial fluid around the joint will be drawn using a needle and analyzed.
- In the case of septic arthritis, there will be changes in the colour, thickness and other attributes of the fluid which will aid in diagnosis.
- Laboratory testing of the fluid involves checking for an increased white blood cell count. It will also help identify the bacteria responsible for the condition. Once identified, appropriate medication can be given for treatment.
- X-rays might also be done to check the extent of joint damage.
- The condition will be treated by draining the fluid which is key to containing the infection and preventing its spread.
- A procedure called joint aspiration will be done wherein the fluid will be removed from the infected joint via a needle and syringe. This procedure might have to be repeated to drain the fluid completely.
- In some cases, keyhole surgery or arthroscopy will be done for fluid removal. Here, small incisions are made and a tube fitted with a camera is inserted into the joint – its output will be seen on a monitor. The doctor, guided by this, will then use suction and tubes to drain the fluid.
- If both these procedures are not feasible, open surgery may be advised.
- The exact procedure will depend on the joint affected.
- A course of antibiotics will also be prescribed. Usually administered intravenously, the antibiotics will help arrest the spread of infection.
- The doctor will also discuss the possible side effects of the antibiotics.
- Initially, hospitalization may be required. Recovery might take around 4-6 weeks.
- In the case of an artificial joint getting infected, the prosthesis will have to be removed. It will not be replaced immediately and a joint spacer will be put in its place. After a few months, when the doctor considers it feasible, a new prosthesis will be installed.
Preventing Septic Arthritis
- As those who have undergone joint replacement are more susceptible to it, they should stay on guard when undergoing other medical procedures. The doctor should be informed as he might want to start the patient on antibiotics before the procedure as a preventive measure.
- If the artificial joint feels sore, warm or inflamed, immediate medical attention should be sought.
- People who have conditions that affect the immune system should also keep their doctors informed before any surgical procedure.
- In the case of diabetes, a strict watch has to be kept over any kind of open wound. If the wound does not heal or it shows signs of worsening, a doctor should be consulted immediately.
- If joint pain follows an infection, it is always better to get it checked by an Orthopedic Doctor.
Early diagnosis and detection are crucial for the successful treatment of any condition, but this takes on a whole new meaning with septic arthritis. Delayed treatment might lead to complete loss of joint mobility. If there is any symptom that is suggestive of septic arthritis, it has to be checked immediately.