Septic Arthritis (Smarty PANCE)

What is the most common cause of septic arthritis in children and adults?

Staphylococcus aureus is the most common cause of septic arthritis in children and adults

What is the most common cause of infectious septic arthritis in young sexually active adults?

Neisseria gonorrhoeae is the most common cause of infectious septic arthritis in young sexually active adults

What is the second most common cause of septic arthritis after S. aureus?

Streptococci spp. is the second most common cause of septic arthritis after S. aureus.

What are two frequently observed organisms causing septic arthritis in those who use IV drugs?

Serratia and Pseudomonas

Which joint is most commonly affected by septic arthritis?

The knee is the joint most commonly affected by septic arthritis; affected joints appear swollen, red, and painful.

Septic arthritis carries a high risk of what?

Septic arthritis carries a high risk of joint destruction and is considered a medical emergency

Gonococcal arthritis may present in what two forms?

Gonococcal arthritis may present in two forms: asymmetric polyarthritis, often with tenosynovitis and dermatitis, usually in the knee or wrist; or purulent monoarthritis

Diagnosis of septic arthritis?

Diagnosis of septic arthritis starts by obtaining synovial fluid from the join via joint aspiration. That synovial fluid is sent for analysis - and typically there’s a high white blood cell count, positive gram stain, or a positive culture - identifying the exact cause. In addition, imaging in the form of an X-ray, ultrasound, CT scan, or MRI can also be very useful in demonstrating bone erosion and joint effusions especially for hip and sacroiliac joints, where synovial fluid aspiration is difficult.

Joints affected by septic arthritis have white blood cell count greater than what?

Joints affected by septic arthritis have purulent synovial fluid, white blood cell count greater than 50,000/mm3, and an elevated erythrocyte sedimentation rate and C-reactive protein

Treatment of septic arthritis typically starts with?

Treatment of septic arthritis typically starts with antibiotic therapy and pain medication. In addition, it may require joint aspiration and washout, which can be done by arthrocentesis. Alternatively it can be done by opening the joint (arthrotomy)