Infectious arthritis

Infectious arthritis (piogenic, septic arthritis) – the difficult infectious disease of joints which is followed by temperature increase, pain, a fever, loss of mobility of the injured joints, their hypostasis and damage.

People of all age are subject to a disease, including, infectious arthritis occurs at children. At adults the disease, as a rule, affects knee joints or hands. At some patients symptoms of a disease are observed not in one, and in several joints. Infectious arthritis quite often causes polyarthritis and defeat of knee, shoulder and hip joints in children.

The group of the increased risk includes the following categories of people:

• with a chronic pseudorheumatism;
• recently receiving intra joint injections;
• recently undergone operation or injury on joints;
• with some types of oncological diseases;
• with homosexual orientation (the risk of developing of gonorrheal arthritis is increased);
• with system infections (HIV infection, gonorrhea);
• diabetics and patients with a sickemia or a system lupus erythematosus;
• with alcohol or drug addiction.

Reasons of infectious arthritis

Preferential the fungal, viral or bacterial infections getting into a joint together with a blood-groove become the reasons of infectious arthritis. Also the activator can get into a joint at surgical intervention or some other way. Emergence of a disease-producing factor depends on age of the patient. Infectious arthritis is caused in the children who were just born, as a rule, by the gonococcal infection transmitted to the child from mother, sick gonorrhea. Also children can get sick as a result of various hospital manipulations including from the entered catheter.

At children up to 2 years staphylococcus aureus or haemophilius influencae acts as pathogens. The senior children and adult patients activators can also have streptococcus viridans and streptococcus pyogenes. As a rule, at sexually active people infectious arthritis is a consequence of infection of Neisseria gonorrhoeae. Elderly people catch under the influence of gram-negative bacteria, such as Pseudomonas and Salmonella.

Symptoms of infectious arthritis

Preferential piogenic arthritis begins suddenly. Sometimes symptoms of infectious arthritis accrue for several weeks. It is followed by swelling of the injured joint and increase in its morbidity.

Symptom of infectious arthritis of a hip joint is pain in inguinal area which becomes very notable at circulation. In most cases at the patient body temperature increases, the fever is felt. Infectious arthritis quite often makes sick and vomiting children.

Local symptoms of infectious arthritis are sharp morbidity at the movement, joint pain, change of its contours, the accruing swelling, disturbance of motive function of an extremity, fervescence.

Complications of infectious arthritis

The disease poses a direct threat not only to health, but also the patient's life as threatens with destruction of bone cartilages or septic shock which preferential leads to a lethal outcome. So, golden staphylococcus can lead to very bystry destruction of cartilages, literally for couple of days. Destruction of cartilaginous tissue leads to the shift of bone joints.

If the infection bacterial, then it can extend in surrounding fabrics and blood, causing blood poisoning or abscesses. The most often found complication of a disease is the osteoarthritis.

Diagnosis of infectious arthritis

The doctor can make the correct diagnosis only after delivery of the corresponding laboratory analyses, attentive studying of a medical card and careful survey of the patient. At diagnosis it is necessary to consider that symptoms of septic arthritis can arise as well at other diseases (rheumatic fever, gout, borreliosis, etc.).

Sometimes the doctor directs the patient to additional consultation to the rheumatologist and the orthopedist with the purpose to avoid the wrong diagnosis.

To confirm the diagnosis, the doctor appoints the following types of researches:

• joint puncture for a detailed research of synovial fluid;
• biopsy and crops of synovial fabric around a joint;
• crops of urine and blood, and also slime from a neck of uterus, etc.

At early stages of septic arthritis hardware diagnosis is not effective (the first 10-14 days after infection).

Treatment of infectious arthritis

As a rule, at infectious arthritis of the patient treat some time permanently, appointing it receptions of medicines and sessions of physical therapy for several weeks or months.

If the disease is revealed at a late stage and threatens with serious violations, then doctors urgently begin intravenous administration of antibiotics. And after identification of the activator the doctor appoints adequate treatment of infectious arthritis.

At viral infections appoint anti-inflammatory nonsteroid drugs. The therapy course intravenous antibiotics makes up to two weeks then prescribe the patient a long course of peroral antibiotics.

The entire period of hospitalization of the patient is under vigilant control of doctors. Daily take synovial fluid on the analysis from the patient. It allows to define efficiency of treatment. As infectious arthritis quite often is followed by strong painful feelings, to the patient appoint the anesthetizing drugs. To protect joints from accidental and sharp movements, to the patient can impose the tire.

In certain cases surgical intervention is applied to treatment of infectious arthritis. Apply it to those patients for whom an antibioticotherapia is not effective, or at serious damages of hip or other joints from which it is problematic to take a puncture. Surgical treatment is preferable also in cases when infectious arthritis is caused by the getting or gunshot wound.

If the patient already had a severe damage of cartilages and bones, the reconstruction surgery can be applied. However it is possible to perform operation only when the infection completely disappears from an organism.

After an extract to the patient recommend to carry out a special complex of the physical exercises promoting faster recovery from hospital.

Forecast of infectious arthritis

The favorable outcome of a disease in many respects depends on how adequate treatment of infectious arthritis was quickly begun. It should be noted that approximately in 70% of cases patients manage to avoid irreversible destruction of joints, but at many patients such complications as partial deformation of joints and an osteoarthritis develop. Children at septic arthritis of a hip joint quite often have a disturbance of region of growth of a bone. Respiratory insufficiency and septic shock become the most frequent reasons of a lethal outcome.