Ct-Ms - 3-22 - Septic Arthritis

Front 1

Acute monoartic pain at rest suggests

Back 1

gout or septic arth

Front 2

damage from arth or trauma puts you at ...

Back 2

10x more risk of infected joint.

Front 3

signs of systemic illness

Back 3

consider SBE, lupus, rheum fever

Front 4

diffuse rash

Back 4

drug reaction

Front 5

discrete skin lesions

Back 5

disseminated gonococcal arth or subacute bacterial endocarditis

Front 6

urethritis, conjunctivitis, arthritis 1-2 weeks after diarrhea or new sex partner

Back 6

reiter's syndrome/reactive arth or gonococcal arthritis.

Front 7

arthrocentesis

Back 7

most important thing to do (tapping the joint). this lets you think of other things that affect joints as well.

tells you the WBC count (how inflamed?), if there is blood in the joint (trauma), crystals in the cjoint (gout or pseudo), and you can culture it (infected?).

Front 8

Cell counts of normal, OA/trauma, RA/SLE/gout, and septic

Back 8

Normal - 0-200

OA/Trauma - 200-2000

RA, SLE, Gout - 2000-50000

Septic - >75000

Front 9

Glucose and prot in a septic joint

Back 9

high protein, low glucose.

Front 10

Pneumatoceles

Back 10

can occur with staph.

pokes holes in the lung.

Front 11

Joints involved in kids?

adults

Back 11

kids - knee hip ankle (load bering = trauam)

adults - shoulder and sternoclavicular.

Front 12

Factors affecting outcome

Back 12

delay in dx

persistently positive joint cultures

prior arthritis - espec RA

hips (worse to be affected than knees)

Front 13

tap joint everyday?

Back 13

yes - just like an abscess.

Front 14

IV drug user px

Back 14

actually good because they recognize the signs of an infection and get tx quickly.

Front 15

Tx

Back 15

effective drainage, debridgement

antibiotics

PT - non weight bearing at first, then early mobilization then splint contractures.

Front 16

advanced septic arthritis needs...

Back 16

surgery

Front 17

Causes of prosthetic joint infection

Back 17

usually coagulative negative staph.

can also be G - aerobic bacilli or staph aureus - with these, remove the prosthesis bc they forma biofilm and antibiotics can't get to it. then antibiotics, repeat culture, reimplant a prosthesis.

Front 18

Definition of prosthetic joint infection

Back 18

infection inthe first year

Front 19

dental prophylaxis?

Back 19

not shown to be realy useful or necessary.

Front 20

abrupt joint swelling with menses, liver pain, migration of pain, and pustular nodules. tenderness of etensor tendons

Back 20

perihepatitis AKA Fitz-Hugh and Curtis syndrome

which was caused by disseminated gonorrhea.

but in this pt, should do blood cultures, aspirate the joint, hemolytic comlement level (many complement def people get infections with capsulated organisms) and urethral and pharyngela cultures

Front 21

migratory arthritides

Back 21

rheum fever and lyme disease

Front 22

Disseminated gonococcal infection

Back 22

Types 1 -dermatitis, tenosynovitis, migratory polyarthritis

Type 2 - septic arthritis

Front 23

Neisseria meningitidis

Back 23

the chronic kind can present just like disseminated gonococcus. you have arthritis and dermatitis.

many people are just carriers for this, but it can kill young people quickly.

Front 24

Viruses associated with arthritis

Back 24

Hepatitis B (also A and C)
Rubella (also rubella vaccine)
Parvovirus B19
Measles
Mumps
Enteroviruses
Alphavirus infections
HIV

Front 25

slapped cheek appearance then extends peripherally.

brought about by heat

Back 25

centrifugal rash (contrast to centripetal which moves centrally e.g. rocky mountain spotted)

this prefers erythroid precursors and can cause anemia.

parvovirus b19

Front 26

things that can cause a rheurmatoid like arthritis in adults

Back 26

rubella and parvovirus

Front 27

parvovirus b19

Back 27

likely on exam. get these things with parvovirus.

get erythema infectiosum (slapped cheeks)

arthritis in adults

aplastic crisis

hydrops fetalis in fetuses (CHF causes edema in the baby)

Front 28

rubella - 3 day measles

Back 28

POSTERIOR CERVICAL AND POSTAURICULAR NODES!!!

syustemic signs.

rash and arthritis

symmetrical small joints.

mimics RA

arthritis may last for months.

1st day on face, 2nd day trunk, 3rd day periphery. then they get over it.

better to get exposued to this as a chiuld (incl vaccine)

Front 29

rubeola virus

Back 29

this is also called regular measles and lasts 7 days.

Front 30

rubella vaccine - post vaccination arthritis

Back 30

after 2 weeks and lasts from a week to a year. occurs in 1/5 of recipients.

Front 31

catchers crouch syndrome

Back 31

after rubella you get lumbar radiculoneuropathy so pain in back of legs so you stand in crouch position as a result.

Front 32

arm syndrome

Back 32

post rubella. brachial neuropathy gives arm and hand pain.

get lmyphcoytes and giant cells (granulomatous) in the arm. treat with TB drugs.

often dont have to remove the prosthesis bc the drugs are so good.

Front 33

Dengue fever

Back 33

Emerging Infectious Diseases

rapid diffuse spread after rainy season.

walk around in bent position

widespread throughout the world.

Front 34

chikungunya fever

Back 34

Emerging Infectious Diseases

walk around in bent position

africa and india

Front 35

he stopped at...

Back 35

slide 67/83 - do we need to do more?