Various types of arthritis are often diagnosed in mature patients. Although in reality there are varieties of pathology that are capable of affecting 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 - everyone should know the answers to these questions in order to identify the defect in time and start the appropriate therapy.
general information
This pathology belongs to the category of severe joint lesions of an infectious nature. She is characterized by severe swelling and redness, a pronounced pain syndrome, the clinical picture of general intoxication of the body.
The pathological process is able to simultaneously cover several different joints. Septic arthritis in patients of different ages is characterized by unequal pathogenesis and flow characteristics. For example, in children, more than one joint is most often affected at the same time: the shoulder, knee and hip. In adult patients, septic arthritis of the ankle joint is most often detected .
Such a 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 a damaged limb, provoking sepsis, and even death. But in the case of timely treatment in most patients, the disease can be eliminated, while avoiding all sorts of complications and the emergence of a chronic form of pathology.
Septic arthritis is an inflammatory serious joint damage that can provoke their rapid destruction. This pathology is closely related to the ingress of various infections pathogens into the tissues, 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 defect:
- primary - pathogenic microorganisms directly affect the joint at the time of its defeat;
- secondary - exposure to microbes occurs on nearby tissues or occurs through the hematogenous route, that is, through the blood.
Risk groups
This disease is quite dangerous and can affect both adults and children. According to statistics, most often men suffer from this vice, as they often ignore all sorts of health problems and injuries.
The increased likelihood of developing septic arthritis increases significantly with:
- chronic form of rheumatoid arthritis;
- severe systemic infections;
- homosexuality;
- certain types of cancer;
- alcohol and drug addiction;
- diabetes mellitus;
- systemic lupus erythematosus ;
- sickle cell anemia;
- joint injuries or surgical intervention;
- intraarticular injection.
Classification
Today, doctors know more than ten varieties of septic arthritis, the most common of which are considered juvenile and seropositive.
The latter 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 entire population.
In no case can you ignore the disease, since serious complications can develop against its background. The causes of this type of arthritis have not yet been fully studied, which prevents full-fledged 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 other words, the body’s immunoglobulins do not bring him benefit, but harm. This pathology lends itself well to therapy, if not delayed with it.
Juvenile arthritis is a chronic joint defect that occurs in children younger than 16 years old. The prerequisites for the development of this pathology also remain a mystery to scientists. Doctors suggest several causes of the onset 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 count on its transition to a state of remission. At the same time, 15% of patients are susceptible to the development of blindness, and the remaining number is prone to relapse.
Etiology
Typically, the development of septic suppurative arthritis is provoked by bacterial, fungal or viral infections that penetrate the joint along with blood circulation, during surgery or in other ways. The occurrence of harmful conditions is also determined by the age category of the patient.
The disease is transmitted to newborn babies from the mother if a gonococcal infection (gonorrhea) is present in her body. In addition, young children can become infected with purulent arthritis during various medical procedures, for example, at the time of insertion of the catheter.
The following can provoke pathology: ARVI, intestinal infection, gonorrhea, influenza, tonsillitis, pneumonia and other defects that have engulfed the joint. Infection often occurs due to trauma, surgery and injection.
As already mentioned, the age of the patient and the variety of the causative agent of the disease are interrelated:
- septic arthritis is provoked by gonococcus in people living an active sex life;
- Staphylococcus aureus can affect human joints at any age;
- Pseudomonas aeruginosa or streptococcus occurs in people with weakened immunity, most often in adulthood;
- in HIV carriers, the disease can be caused by opportunistic microorganisms and fungi.
Infections that provoke septic arthritis periodically occur in many people, but the progression of pathology does not occur in everyone. After all, with full immunity, a healthy joint is well protected from the penetration of pathogenic bacteria.
In the zone of greatest risk are people suffering from:
- any forms of immunodeficiency;
- blood and blood anomalies;
- various chronic pathologies in the period of exacerbation;
- joint changes of a non-infectious nature.
In addition, the likelihood of the onset of septic arthritis in those who wear a prosthesis, and was also bitten by insects or animals.
Symptoms of the disease
Septic arthritis manifests itself quite quickly: only a few hours after infection in the form of restrictions on both active and passive movements. There is a chill, general weakness and fever. 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 manifest as minor pain after prolonged physical exertion on an injured joint. The disease progresses within a few months, after which the symptoms become much more serious.
The purulent form of septic arthritis in children carries a great danger to the health and even life of a small patient, since 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 at the time of movement;
- symptoms of the inflammatory process - fever, local hyperemia, swelling;
- dermatitis syndrome - periarthritis.
The diagnosis can be confirmed on the basis of a characteristic x-ray picture, a set of typical signs and the results of microbiological analyzes.
Disease localization
This pathology is characteristic of all age categories, including newborn babies, without exception. In adult patients, the hands or joints, which take the maximum load, often suffer. In children, septic arthritis of the knee joint, as well as the hip and shoulder structures, is very common.
Since pathology can cause deformation and a forced change in the position of the limbs, it is possible to distinguish certain external signs of the disease. Photos of the symptoms of septic arthritis demonstrate visual manifestations of the defect, according to which it is very easy to determine the ailment even on your own.
- When the elbow is injured, its protrusion looks smoothed, the hand bends a little. In this case, a painful tumor may form on the opposite side.
- When the wrist joint is damaged, it is sharply deformed, because of which the hand bends to the side.
- With septic arthritis of the left shoulder joint, the corresponding shoulder becomes slightly depressed, the diseased limb is constantly bent at the elbow and is supported by a healthy right hand.
- In case of damage to the hip joint, the formation of edema in the injured area is observed, there is no way to lean on the leg.
- In case of damage to the ankle structure, the foot gains a slightly elevated appearance, while the patient's mobility is significantly limited.
- With septic arthritis of the knee, the latter acquires an informal look, and a damaged limb bends involuntarily, which interferes with normal movement.
Diagnostics
The final diagnosis is made by the doctor after carrying out all the necessary microbiological tests, examining the medical records and thorough examination of the patient. Symptoms of septic arthritis are inherent in many other diseases, so a patient examination before prescribing therapy is required.
Sometimes patients are prescribed additional consultation with an orthopedist or rheumatologist in order to avoid making the wrong diagnosis. In addition, auxiliary diagnostic methods are used:
- joint puncture for the study of synovial fluid;
- biopsy and culture for the study of synovial tissues located next 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 uninformative. For this reason, when the initial symptoms appear, specialists refer the patient to other examinations, with which you can identify the pathology at an early stage of development and begin to treat it.
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 hospitalized 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 the aggressiveness of its course.
Medications are usually used in case of late detection of a pathology, when it is already capable of provoking serious complications. In this case, the intravenous administration of antibiotics is prescribed to the rhinestone after diagnosis of arthritis. And after determining the type of pathogen, the patient is prescribed a drug that acts on certain bacteria.
As a rule, patients with a diagnosis of septic arthritis are recommended a two-week course of taking non-steroidal anti-inflammatory drugs in the form of intravenous injections. And after it, the patient is prescribed antibacterial medications 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 necessary only for those patients who have a certain resistance or lack of sensitivity to antibiotics, as well as people who have encountered infection of joints in hard-to-reach places. Another prerequisite for surgery is a penetrating wound.
For patients with serious injuries of bones and cartilage, reconstructive surgery is used, which is carried out only after complete disposal of the infection.
Concomitant treatment and qualified monitoring consists of inpatient therapy, during which the patient is under constant monitoring. Every day, a sample of synovial fluid is taken from the patient to determine the body's response to antibiotic exposure.
To get rid of the pain syndrome in the damaged area, special preparations and compresses are also applied that are applied to the affected joints.
In some situations, immobilization is carried out, which involves the application of a tire to an injured limb to ensure that it is completely immobile. Among other things, the patient is recommended physiotherapy exercises, which is required to increase the amplitude of movements and faster recovery.
Effects
Septic arthritis is a protracted pathology that entails the development of diseases such as sepsis and purulent inflammation of the soft tissues. It is also very likely the appearance of dislocations, sprains, displacement of bones, their inflammation, dehydration of the damaged joint.
In the case of timely antibacterial treatment of septic arthritis, a further prognosis is very favorable. And this means that the patient has the opportunity to completely repair damaged areas of the body.