Septic Arthritis



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Septic Arthritis is an infection in a joint. Bacteria, or less commonly fungi, can spread from other infected areas in your body to the joint. Sometimes bacteria infect only the joint, leaving other areas of your body unharmed.

In this disease, germs infiltrate the joint and damage it, causing severe pain. Bacteria most commonly target your knee, though other joints can be affected, including your ankle, hip, wrist, elbow and shoulder. Septic arthritis usually affects just one joint, though occasionally it may occur in more than one joint at a time.

Young children and older adults are most likely to develop septic arthritis. As the population ages, doctors are finding that septic arthritis is becoming more common. Prompt treatment with antibiotics and occasionally with surgery is essential to limiting the amount of joint damage that this disease causes.

Symptoms:

  • Fever
  • Shaking chills
  • Severe pain in the affected joint, especially when you move that joint
  • Swelling of the affected joint
  • Warmth in the area of the affected joint

  • People taking medications for other types of arthritis may not feel severe pain with septic arthritis, since those medications may mask the pain and fever.

    The joints of your arms and legs are most commonly affected. In rare cases other joints, such as those in your back, neck and head, may be affected.

    Causes:

    It can begin as an infection elsewhere in your body and travel through your bloodstream to the joint. What may begin as an upper respiratory tract infection or urinary tract infection can spread in your body and cause septic arthritis. Less common causes include puncture wounds, surgery and drug injections, which can allow bacteria into your body near the affected joint. In other cases, bacteria may enter your body and circulate in your bloodstream, but not cause an infection anywhere else — just in your affected joint.

    The lining of your joints has little to protect it from infection. Once bacteria reach the synovium, they enter easily and can begin damaging cartilage. Your body reacts to the bacteria by causing inflammation around the joint. This increases pressure in your joint and reduces blood flow to the joint, joining in the destruction of your joint.

    . . . Types of bacteria A number of strains of bacteria can cause this disease. The most common type involved in septic arthritis is Staphylococcus aureus — a type of bacteria commonly found on your skin and in your nose.

    In the past, septic arthritis was more frequently caused by the bacterium that causes the sexually transmitted disease gonorrhea. But better use of safer-sex practices has led to a decline in gonorrhea and its complications, including septic arthritis. Still, in younger sexually active people, gonorrhea is a more likely cause of septic arthritis.

    . . . Other infectious causes of arthritis Bacteria are just one cause of joint infections. Viruses also can attack joints, though this condition usually resolves on its own and causes little joint damage. In rare cases, joint infections can be caused by a fungus. Another infection-related type of arthritis is reactive arthritis, which causes joint pain in response to an infection in another part of the body, though the infection doesn't actually occur in the joint.

    Treatment:

    . . . Antibiotics Your doctor works to identify the bacterium that's causing your infection and then selects the most effective antibiotic to target that specific bacterium. Antibiotics may be given through a vein in your arm at first. Later, in some cases, you may be able to switch to oral antibiotics. How long you undergo antibiotic treatment depends on your health, your particular bacterium and the extent of the infection, but expect about two to six weeks of treatment.

    Antibiotics carry a risk of side effects, including nausea, vomiting and diarrhea. Allergic reactions also can occur. Talk to your doctor about the side effects to expect from your specific medication.

    . . . Joint drainage Removing the infected synovial fluid from your joint serves three purposes: It removes bacteria from your joint, it reduces pressure on your joint, and it gives your doctor a sample to test for bacteria and other organisms. The most common method of removing joint fluid is through arthroscopic surgery. During this surgery, tiny cameras and special surgical tools are inserted through small incisions around your joint to access and drain the fluid around the joint.

    In other cases, doctors may remove fluid from your joint with a needle. Arthrocentesis may be repeated, usually daily, until no bacteria are found in the extracted fluid. Hips, which are more difficult to access, may require open surgery to remove the synovial fluid. Open surgery requires larger incisions to pull back the skin and access your joint. Surgery may need to be repeated in certain cases.

    . . . Recovery Once the infection is under control, your doctor may recommend gentle movement to keep your joint nimble. Gentle exercises can keep your joint from becoming stiff and your muscles from becoming weak. Movement also encourages blood flow and circulation, which helps your body's healing process.

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    ...less medical jargon in a 'Quick Glance' format!