Septic Arthritis, Septic Bursitis, and Osteomyelitis

2018 ◽  
Author(s):  
Cameron Ashbaugh
Keyword(s):  
Differential Diagnosis ◽  
Septic Arthritis ◽  
Vertebral Body ◽  
Bone Infection ◽  
Host Factors ◽  
Mechanical Support ◽  
Posttraumatic Osteomyelitis ◽  
Therapeutic Goal ◽  
Septic Bursitis

Infections of joints and bones are important causes of morbidity due to the potential for permanent injury to structures necessary for mechanical support and useful motion. The spectrum of disease is broad, with host factors, pathogen, site of infection, and comorbidities all influencing outcome. In some cases of bone infection, cure may not be possible, and the therapeutic goal becomes control. This review details the epidemiology, pathogenesis, diagnosis, differential diagnosis, treatment, and prognosis of septic arthritis, septic bursitis, vertebral body osteomyelitis, pedal osteomyelitis in association with diabetes, and chronic posttraumatic osteomyelitis with union or malunion. This review contains 13 highly rendered figures, 16 tables, and 192 references.

Septic Arthritis, Septic Bursitis, and Osteomyelitis

2018 ◽  
Author(s):  
Cameron Ashbaugh
Keyword(s):  
Differential Diagnosis ◽  
Septic Arthritis ◽  
Vertebral Body ◽  
Bone Infection ◽  
Host Factors ◽  
Mechanical Support ◽  
Posttraumatic Osteomyelitis ◽  
Therapeutic Goal ◽  
Septic Bursitis

Infections of joints and bones are important causes of morbidity due to the potential for permanent injury to structures necessary for mechanical support and useful motion. The spectrum of disease is broad, with host factors, pathogen, site of infection, and comorbidities all influencing outcome. In some cases of bone infection, cure may not be possible, and the therapeutic goal becomes control. This review details the epidemiology, pathogenesis, diagnosis, differential diagnosis, treatment, and prognosis of septic arthritis, septic bursitis, vertebral body osteomyelitis, pedal osteomyelitis in association with diabetes, and chronic posttraumatic osteomyelitis with union or malunion. This review contains 13 highly rendered figures, 16 tables, and 192 references.

Septic Arthritis and Osteomyelitis

2016 ◽  
Author(s):  
Melissa Leber
Keyword(s):  
Antibiotic Therapy ◽  
Septic Arthritis ◽  
Vertebral Body ◽  
Joint Destruction ◽  
Vertebral Osteomyelitis ◽  
Initial Evaluation ◽  
Joint Disease ◽  
Diabetic Patients ◽  
Posttraumatic Osteomyelitis ◽  
Neuropathic Ulcers

Septic arthritis is an inflammatory condition within the joint in reaction to bacterial infection in the joint space. Emergent diagnosis and initiation of therapy are necessary to prevent joint destruction and, in some cases, serious systemic illness. This review covers the epidemiology, assessment and stabilization, diagnosis, treatment and disposition, and outcomes of septic arthritis. Figures show the pathophysiology of bone infection; an algorithm for the initial evaluation and management of a suspected septic joint; a magnetic resonance image of vertebral body osteomyelitis; a cutaneous sinus in a patient with underlying chronic posttraumatic osteomyelitis at the site of a previous tibial fracture; the probe-to-bone test for diagnosing osteomyelitis in the diabetic foot; an algorithm for the initial evaluation and management of suspected vertebral body osteomyelitis; nonsurgical treatment of osteomyelitis of the foot in a patient with diabetes; and algorithms for the evaluation and management of osteomyelitis in diabetic patients with neuropathic ulcers and no or mild foot infection, osteomyelitis in diabetic patients with neuropathic ulcers and moderate or severe foot infection, and chronic posttraumatic osteomyelitis. Tables list supportive findings for diagnosis of chronic osteomyelitis, risk factors for the development of septic arthritis in patients with underlying joint disease, microbiology in septic arthritis, empirical antibiotic therapy for septic arthritis, microbiology in vertebral osteomyelitis, antibiotic therapy for vertebral osteomyelitis awaiting culture results, representative studies with likelihood ratios for diagnostic tests used in the evaluation of native joint septic arthritis, antibiotic therapy for vertebral osteomyelitis with unknown or established microbiology, and antibiotic therapy for diabetic pedal osteomyelitis with unknown or established microbiology.   Key words: osteomyelitis, probe-to-bone test, septic arthritis, septic joint, vertebral osteomyelitis This review contains 10 highly rendered figures, 9 tables, and 110 references.

scholarly journals Utilisation of musculoskeletal ultrasonography for the evaluation of septic arthritis in a patient presenting to the emergency department with fever during the era of COVID-19

2021 ◽  
Vol 14 (4) ◽  
pp. e242370
Author(s):  
Jiodany Perez ◽  
Stefani Sorensen ◽  
Michael Rosselli
Keyword(s):  
Emergency Department ◽  
Septic Arthritis ◽  
Glenohumeral Joint ◽  
Imaging Modality ◽  
Point Of Care ◽  
Significant Morbidity ◽  
Anchoring Bias ◽  
Septic Bursitis ◽  
Musculoskeletal Ultrasonography ◽  
Point Of Care Ultrasonography

Prompt recognition and treatment of septic arthritis are crucial to prevent significant morbidity and mortality in affected patients. During the current COVID-19 pandemic, anchoring bias may make an already challenging diagnosis like septic arthritis more difficult to diagnose quickly and efficiently. Musculoskeletal (MSK) point of care ultrasonography (POCUS) is an imaging modality that can be used to quickly and efficiently obtain objective findings that may help a clinician establish the diagnosis of septic arthritis. We report a case where MSK POCUS was a key element in establishing the diagnosis of glenohumeral joint septic arthritis and subdeltoid septic bursitis for a patient that presented to the emergency department with a fever during the era of the COVID-19 pandemic.

scholarly journals Application of a Novel Diagnostic Rule in the Differential Diagnosis between Acute Gouty Arthritis and Septic Arthritis

2015 ◽  
Vol 30 (6) ◽  
pp. 700 ◽  
Author(s):  
Kwang-Hoon Lee ◽  
Sang-Tae Choi ◽  
Soo-Kyung Lee ◽  
Joo-Hyun Lee ◽  
Bo-Young Yoon
Keyword(s):  
Differential Diagnosis ◽  
Septic Arthritis ◽  
Gouty Arthritis ◽  
Acute Gouty Arthritis

Monoarticular disease

2013 ◽  
pp. 63-68
Author(s):  
Mark Lillicrap ◽  
Shazia Abdullah
Keyword(s):  
Differential Diagnosis ◽  
Light Microscopy ◽  
Septic Arthritis ◽  
Polarized Light ◽  
Diagnostic Reasoning ◽  
Polarized Light Microscopy ◽  
Primary Concern ◽  
Gram Stain ◽  
Acute Setting ◽  
Careful History

Non-traumatic monoarthritis is a common presenting problem in both primary and secondary care. The differential diagnosis is broad, encompassing both inflammatory and non-inflammatory causes. A careful history and examination will allow the underlying cause to be elicited in many cases. However, particularly in the acute setting, the history and examination findings do not allow exclusion of the diagnosis of primary concern-septic arthritis. Arthrocentesis with Gram stain and culture of the aspirated fluid, alongside polarized light microscopy, is the key initial investigation in any patient with an acute monoarthritis. Additional laboratory and radiological investigations can supplement the diagnostic reasoning process, in cases where the diagnosis remains unclear.

Antimicrobial peptides UBI29-41 and UBI18-35 radiolabeled with 99mТс for differential diagnosis of bone infection of the limbs

2020 ◽  
Vol 170 (10) ◽  
pp. 420-425
Author(s):  
V. D. Zavadovskaya ◽  
◽  
M. S. Larkina ◽  
E. S. Stasyuk ◽  
M. A. Zorkaltsev ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Antimicrobial Peptides ◽  
Bone Infection

A guideline for differential diagnosis between septic arthritis and transient synovitis in the ED: a Delphi survey

2016 ◽  
Vol 34 (8) ◽  
pp. 1631-1636 ◽  
Author(s):  
Jin Hee Lee ◽  
Moon Seok Park ◽  
Hyuksool Kwon ◽  
Chin Youb Chung ◽  
Kyoung Min Lee ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Septic Arthritis ◽  
Delphi Survey ◽  
Transient Synovitis

scholarly journals Shoulder Septic Arthritis

2018 ◽  
pp. 17-22
Author(s):  
Ivan Copete-González ◽  
Joan Ferràs-Tarragó ◽  
Manuel Ángel Angulo Sánchez
Keyword(s):  
Differential Diagnosis ◽  
Surgical Treatment ◽  
Septic Arthritis ◽  
Protein Chain ◽  
Hematogenous Spread ◽  
Chain Reaction ◽  
Intravenous Antibiotic ◽  
Direct Inoculation ◽  
Process Material

Background: Septic arthritis is an emergency in orthopedics. Several mechanisms have been described: hematogenous spread, extension from an adjacent focus and direct inoculation, being the first one the most frequent mechanism. If not handled properly neither early, what can lead to the destruction of the articular cartilage and the production of sequelae. In an incipient case, good results can be got with conservative treatment, but usually surgical management is necessary for the resolution of the process. Material and Methods: We present a case of a 5 year old child who suffered an episode of arthritis after the administration of vaccine against serogroup B Neisseria Meningitidis. Symptoms began 2 hours after vaccination with pain and fever of up to 39ºC. At this moment, arthrocentesis was performed and intravenous antimicrobial therapy was initiated. Results: The evolution was favorable with no need of surgical treatment. Symptoms continued going down after the management with arthrocentesis and intravenous antibiotic treatment, until disappearing completely in a few days. During the follow-up, no signs of recurrence have appeared after 12 months. Conclusions: despite the fact that the hematogenous spread is the most frequent mechanism of establishment of arthritis septic, direct inoculation can justify a case of arthritis after vaccination in the deltoid region. We must be careful during vaccination with bacteria toxoids in the deltoid region, due to the risk of reactive arthritis and its differential diagnosis with septic arthritis. More studies are needed to clarify the diagnoses in the borderline cases, being molecular biology techniques as protein chain reaction a fast and useful tool.

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