Suppurative arthritis – an acute infectious disease. Vulnerable to septic arthritis of the major joints of the upper and lower extremities, in particular, is a purulent arthritis of the shoulder joint and knee. Ankle, hip and elbow joints are affected less frequently.
Doctors distinguish primary and secondary forms of the disease. Primary develops after contact with infectious pathogens through open wounds. Secondary infection through the neighboring tissue. The main pathogens is staph bacteria, Pseudomonas aeruginosa, aerobic flora. Septic arthritis secondary type affects joint bags and synovium of the joints. Cartilage resistant to infections, but gradually the metabolism in the joint. Cartilage is susceptible to infection and products of its decay. The disease develops in both adults and children.
If suppurative arthritis is discovered in a child, in some cases, the pathogen may not be found. The reasons for the development of septic arthritis may be several. It is open wounds (operative wound, sprains, fractures, gunshot wound), infectious processes in the adjacent tissues (osteomyelitis, thrombophlebitis), infectious processes in the body (pneumonia, furunculosis, otitis, sepsis, tuberculosis).
Inflammation in joints can occur quickly and be life-threatening, especially for the newborn baby. With the development of the disease to consider the overall resistance of the organism and the species of the pathogen of purulent inflammation of the joint. Infectious inflammation of the knee and hip often ill children and the elderly. Immune system the elderly are more vulnerable to various infections. Children with purulent-septic infection in blood, was injured, can develop a purulent arthritis.
Symptoms of the disease
Symptoms are manifested external and internal signs. Internal symptoms are common, these include:
- high temperature;
- yellowed skin;
External symptoms relate to the affected joint: it is swollen, the skin around it is red, is manifested hyperthermia (temperature change of the affected area), pain when pressed and walking. With these symptoms should immediately consult a doctor.
To ease the pain, the diseased joint is fixed in a certain position. It must be done only by a doctor. After that, patients are assigned tests and x-rays. In some cases, radiography revealed no pathology. In this case, symptoms may be delayed. For arthritis, especially the knee, diagnosing the disease difficult.
To identify the causative agent appointed by the puncture, as well as the General analysis of blood. The results of the external examination, radiography, blood tests, and puncture is determined by the type of purulent arthritis and treatment. With the course of the disease form of the joint changes. Treat suppurative arthritis as soon as possible, as the disease is destructive in nature.
If treatment is not started in time, the clinical picture is added to the following symptoms.
The progression of the disease leads to disruption of motor function and even disability, especially in lesions of the knee and hip joints.
The treatment of septic arthritis is made in the complex. It involves immobilization of the joint, medications, puncture to removal of pus and, in extreme cases, surgical treatment.
Selection of medicines is thoroughly. Since staphylococcal pathogens every year develop resistance to antibiotics, the doctor spends the antibiogram. It shows how the drugs are combined with each other and than they can be replaced so that treatment would be more effective. Semi-synthetic penicillin drugs successfully compete with purulent secretions. They are used in conjunction with antibiotics. Otryvanov derivatives and sulfonamides increase the quality of treatment.
|The first step is immobilization of the joint.||The type of immobilization depends on the affected joint. For example, septic arthritis knee joint for fixation using orthopedic knee braces.|
|Then assigned to anti-infective drugs.||Antibiotics in high concentration is administered intramuscularly or intravenously several times a day.|
|Puncture is used to remove the pus accumulated in the articular capsule.||This is an outpatient method of treatment. Tool for the procedure – sterile syringe with a volume of 10-20 ml, it needs to be with a thick needle. Needle deep, just one-half inch, so as not to injure the joint shell. The skin before puncture slightly pulled to the synovial fluid did not come out through the skin.|
When carrying out the puncture to remove the purulent content, the professionalism of the doctor is very important: the traffic specialist should be light, precise and accurate.
Indications for puncture and surgery
The method of the puncture is to remove pus depends on the joint because they have a different structure. For example, puncture of the shoulder can be of three types: front, rear, side. In all cases, the doctor inserts a needle near the acromial-key connection, perpendicular to the skin, then directing the needle in the right direction.
Puncture of the knee joint is in the region of the patella, its upper end part. The doctor directs the needle under the tendon of the quadriceps, passing through the tendon to bone. Puncture of the knee joint is one of the most difficult, but the diagnosis of purulent arthritis of the knee is the best diagnostic method. After the pus is removed, the affected area is washed with antiseptic. In this case, anti-infective medications are administered directly into the joint.
Doctors carried out several biopsies depending on the condition of the patient. When the liquid is converted into serous, the procedure is stopped. If the patient has the acute form of the disease, then pumping fluid, physiotherapy and some medicines are prohibited.
If the applied treatments did not help or you want to decompress urgently arthrotomy is performed: the joint is opened, remove the infected tissue. Then it is disinfected with antiseptic, injected with antibiotics, establish a drainage system to control the outflow and inflow of fluids.
The ineffectiveness of the arthrotomy, the doctor makes the decision about the removal of the affected joint. All operations are carried out under General anesthesia: General and local. It is important that the operation was conducted by a highly qualified specialist, in some cases, the patient’s condition may deteriorate. There is a risk of development of arthrosis, and recurrence of septic arthritis.
The surgical technique used when absolutely necessary if conservative treatments have failed and symptoms are progressing.