Different types of arthritis are often diagnosed in patients of mature age. Although in reality there are varieties of pathology that can affect absolutely everyone, regardless of the number of years. One such form is septic arthritis. What it is, how the disease manifests itself and how it is treated - every person should know the answers to these questions in order to identify the defect in time and proceed to appropriate therapy if necessary.
General information
This pathology belongs to the category of severe joint lesions of an infectious nature. It is characterized by severe swelling and redness, a pronounced pain syndrome, a clinical picture of general intoxication of the body.
The pathological process is able to cover several different joints at the same time. Septic arthritis in patients of different ages is characterized by unequal pathogenesis and course features. For example, in children, several joints are most often affected simultaneously: shoulder, knee and hip. In adult patients, septic arthritis of the ankle is the most common.
Thisthe disease is also dangerous because it has various symptoms that make it difficult to diagnose and, accordingly, treat.
Infectious arthritis - what is it
Without proper treatment, septic arthritis is quite capable of causing amputation of an injured limb, provoking sepsis and even leading to death. But in the case of timely treatment in most patients, the disease can be eliminated, while avoiding all sorts of complications and the onset of a chronic form of pathology.
Septic arthritis is a serious inflammatory disease of the joints that can provoke their rapid destruction. This pathology is closely related to the penetration of various infectious agents into the tissues of the joints, for example, with sepsis.
Infectious arthritis is a fairly large group that includes a combination of many infectious and inflammatory processes - allergic, autoimmune, reactive and others.
There are two forms of this vice:
- primary - pathogenic microorganisms directly affect the joint at the time of its damage;
- secondary - the impact of microbes falls on nearby tissues or occurs hematogenously, that is, through the blood.
Risk groups
This disease is quite dangerous and can affect both adults and children. According to statistics, men are most often affected by this vice, as they often ignore all sorts of he alth problems and injuries.
Increased likelihood of developing septicarthritis increases significantly with:
- chronic form of rheumatoid arthritis;
- severe systemic infections;
- homosexuality;
- certain types of cancer;
- alcohol and drug addiction;
- diabetes;
- systemic lupus erythematosus;
- sickle cell anemia;
- injury to the joints or surgery;
- intra-articular injections.
Classification
Today, doctors know more than ten varieties of septic arthritis, the most common of which are juvenile and seropositive.
The last type is a pathology of a chronic form, which manifests itself as damage to the joints, as well as destructive changes in blood vessels and internal organs. This defect is considered extremely common, as it is diagnosed in 80% of the general population.
Ignore the disease in any case, it is impossible, because against its background, severe complications can develop. The causes of this type of arthritis are not yet fully understood, which prevents full prevention. Presumably, the onset of the disease is influenced by a variety of mycoplasmas and viruses, which are accompanied by such conditions: trauma, toxins, genetic predisposition, stress, old age.
Seropositive arthritis is autoimmune in nature, in other words, the body's immunoglobulins do not benefit it, but harm it. This pathology responds well to therapy,if you do not delay with it.
Juvenile arthritis is a chronic joint disease that occurs in children under 16 years of age. The prerequisites for the development of this pathology also remain a mystery to scientists. Doctors suggest several causes of the disease: viral and bacterial infections, severe injuries, insolation, hypothermia, taking protein medications.
The main factor for the onset of juvenile arthritis, according to many doctors, is the formation of a complex immune response of the body to external circumstances.
The prognosis for this pathology is not particularly favorable, since only 50% of patients can expect it to go into remission. At the same time, 15% of patients are prone to the development of blindness, and the remaining number - the appearance of relapses.
Etiology
Usually, the development of septic purulent arthritis is provoked by bacterial, fungal or viral infections that enter the joint along with the blood circulation, during surgery or in other ways. The occurrence of harmful conditions is also determined by the age category of the patient.
To newborn babies, the disease is transmitted from the mother in the presence of gonococcal infection (gonorrhea) in her body. In addition, small children can become infected with purulent arthritis during all kinds of medical procedures, for example, at the time of insertion of a catheter.
Can provoke pathology: SARS, intestinal infection, gonorrhea, influenza, tonsillitis, pneumonia and other vices,covering the joint. Infection often occurs due to trauma, surgery and injections.
As already mentioned, the age of the patient and the type of pathogen are interrelated:
- septic arthritis is caused by gonococcus in people who have an active sex life;
- Staphylococcus aureus can affect a person's joints at any age;
- Pseudomonas aeruginosa or streptococcus occurs in immunocompromised people, most often in adulthood;
- Possible pathogens and fungi can cause disease in HIV carriers.
Infections that provoke septic arthritis occur periodically in many people, but the progression of the disease does not occur in everyone. Indeed, with full immunity, a he althy joint is well protected from the penetration of pathogenic bacteria.
At the highest risk are people suffering from:
- any form of immunodeficiency;
- anomalies of hematopoiesis and blood;
- various chronic pathologies in the period of exacerbation;
- non-infectious joint changes.
In addition, those who wear a prosthesis and have been bitten by insects or animals are more likely to develop septic arthritis.
Symptoms of disease
Septic arthritis appears quite quickly: just a few hours after infection in the form of a limitation of both active and passive movements. Chills, general weaknessand an increase in body temperature. In the area of the damaged joint, redness and swelling of the tissues occurs.
In children, this defect has a mildly erased clinical picture. Symptoms are manifested in the form of minor pain after prolonged physical exertion on the injured joint. The disease progresses over several months, after which the symptoms become much more serious.
The purulent form of septic arthritis in children carries a great danger to the he alth and even the life of a small patient, as it can lead to the destruction of bone tissue and cartilage. In addition, such a disease can lead to septic shock, which, in turn, often provokes a fatal outcome. Signs of the presence of such a pathology in the child's body are manifested in the form of pain, chills, fever, nausea and vomiting.
In general, the clinical picture is characterized by:
- acute pain during movement;
- symptoms of the inflammatory process - fever, local hyperemia, swelling;
- dermatitis-periarthritis syndrome.
Diagnosis can be confirmed on the basis of a characteristic x-ray picture, a combination of typical features and microbiological findings.
Disease localization
This pathology is typical for all age categories without exception, including newborn babies. In adult patients, the hands orjoints that bear the maximum load. Septic arthritis of the knee joint and of the hip and shoulder structures is very common in children.
Since pathology can cause deformity and a forced change in the position of the limbs, certain external signs of the disease can be distinguished. Photos of the symptoms of septic arthritis demonstrate visual manifestations of the defect, by which it is very easy to determine the disease even on your own.
- When the elbow is injured, its protrusion looks smoothed, the arm is slightly bent. In this case, a painful swelling may form on the opposite side.
- When the wrist joint is affected, it is sharply deformed, due to which the hand bends to the side.
- In septic arthritis of the left shoulder joint, the corresponding shoulder becomes slightly depressed, the diseased limb is constantly bent at the elbow and supported by a he althy right hand.
- In case of damage to the hip joint, edema is formed in the injured area, it is impossible to lean on the leg.
- When the ankle structure is affected, the foot gets a slightly elevated appearance, while the patient's mobility is significantly limited.
- In septic arthritis of the knee joint, the latter becomes unformal, and the injured limb bends involuntarily, which interferes with normal movement.
Diagnosis
The final diagnosis is made by a doctor after allnecessary microbiological tests, study of the medical record and a thorough examination of the patient. Symptoms of septic arthritis are inherent in many other diseases, so examination of the patient before prescribing therapy is required.
Sometimes patients are assigned an additional consultation with an orthopedist or rheumatologist to avoid misdiagnosis. In addition, auxiliary diagnostic methods are used:
- Joint puncture to examine synovial fluid;
- biopsy and culture to examine synovial tissue adjacent to the damaged structure;
- analysis of urine and blood to determine the bacterial and biochemical state of the body.
Instrumental diagnosis of septic arthritis in the first weeks after the onset of the disease is not informative. For this reason, when initial symptoms appear, specialists refer the patient to other examinations, with the help of which it is possible to identify the pathology at an early stage of development and begin its treatment.
Among other things, it is very important to make a differential diagnosis of septic arthritis and arthrosis - these diseases are extremely similar in their clinical manifestations.
Therapy
If septic arthritis is detected, the patient must be admitted to the hospital for several days. In this case, the patient is prescribed physiotherapeutic procedures and drug therapy. The duration of the course of treatment depends on the age of the patient, the stage of the disease and its aggressiveness.flow.
Medicines are usually used in case of late detection of pathology, when it is already capable of provoking serious complications. In this case, intravenous antibiotics are prescribed immediately after the diagnosis of arthritis. And after determining the type of pathogen, the patient is prescribed a remedy that affects certain bacteria.
Typically, patients diagnosed with septic arthritis are recommended a two-week course of non-steroidal anti-inflammatory drugs in the form of intravenous injections. And after it, the patient is prescribed antibacterial medicines in the form of tablets or capsules for a period of 4 weeks.
Surgical intervention is necessary in cases where surgical drainage of damaged joints is required. This is only necessary for those patients who have a certain resistance or lack of sensitivity to antibiotics, as well as people who have experienced infection of joints in hard-to-reach places. Another prerequisite for the operation is a penetrating wound.
For patients with serious injuries of bones and cartilage, reconstructive surgery is used, which is carried out only after complete elimination of infection.
Concomitant treatment and qualified supervision consists of inpatient therapy, during which the patient is under constant supervision. Every day, a sample of synovial fluid is taken from the patient to determine the body's response to exposure.antibiotics.
To get rid of pain in the damaged area, special preparations and compresses are also used, which are applied to the affected joints.
In some situations, immobilization is carried out, which involves the imposition of a splint on the injured limb to ensure it is completely immobile. Among other things, the patient is recommended physical therapy, which is required to increase the range of motion and faster recovery.
Consequences
Septic arthritis is a protracted pathology that entails the development of diseases such as sepsis and purulent inflammation of the soft tissues. Also, the appearance of dislocations, sprains, displacement of bones, their inflammation, dehydration of the damaged joint is very likely.
In case of timely antibiotic treatment of septic arthritis, the further prognosis is very favorable. And this means that the patient has the opportunity to completely restore the damaged areas of the body.
