Infectious arthritis (septic arthritis)

Infectious arthritis (pyogenic, septic arthritis) is a complex infectious disease of the joints, accompanied by fever, pain, chills, loss of mobility of injured joints, their swelling and damage.

People of all ages are susceptible to the disease, including infectious arthritis in children. In adults, the disease usually affects the knee joints or hands. In some patients, the symptoms of the disease are observed not in one, but in several joints. Infectious arthritis in children often causes polyarthritis and damage to the knee, shoulder, and hip joints.

The high-risk group includes the following categories of people:

  • with chronic rheumatoid arthritis,
  • recently received intra-articular injections,
  • recently undergone surgery or injury to the joints,
  • with some types of cancer,
  • with homosexual orientation (increased risk of gonorrheal arthritis),
  • with systemic infections (HIV, gonorrhea),
  • diabetics and patients with sickle cell anemia or systemic lupus erythematosus,
  • with alcohol or drug addiction.

Causes of Infectious Arthritis

The main causes of infectious arthritis are fungal, viral or bacterial infections that enter the joint along with the bloodstream. Also, the pathogen can get into the joint with surgery or other means. The occurrence of the disease factor depends on the age of the patient. Infectious arthritis in children who have just been born is usually caused by a gonococcal infection transmitted from a mother with gonorrhea to a child. Children can also get sick as a result of various hospital procedures, including from the inserted catheter.

Staphylococcus aureus or haemophilius influencae acts as pathogens in children under 2 years of age. In older children and adult patients, streptococcus viridans and streptococcus pyogenes can also become pathogens. In sexually active people, infectious arthritis is usually caused by infection with Neisseria gonorrhoeae. Older people become infected with gram-negative bacteria such as Pseudomonas and Salmonella.

Symptoms of infectious arthritis

Mostly pyogenic arthritis begins suddenly. Sometimes symptoms of infectious arthritis increase over the course of several weeks. This is accompanied by swelling of the damaged joint and an increase in its pain.

Symptom of infectious arthritis of the hip joint is pain in the groin area, which becomes very noticeable when walking. In most cases, the patient's body temperature rises, fever is felt. In children, infectious arthritis often causes nausea and vomiting.

Local symptoms of infectious arthritis are a sharp pain when moving, pain in the joint, a change in its contours, increasing swelling, impaired motor function of the limb, an increase in body temperature.

Complications of Infectious Arthritis

The disease poses a direct threat not only to the health, but also to the life of the patient, as it threatens with the destruction of bone cartilage or septic shock, which is predominantly fatal. So, Staphylococcus aureus can lead to very rapid destruction of cartilage, in just a couple of days. The destruction of cartilage tissue leads to displacement of the bone joints.

If the infection is bacterial, it can spread to the surrounding tissues and blood, causing infection of the blood or abscesses. The most common complication of the disease is osteoarthritis.

Diagnosis of Infectious Arthritis

A doctor can make a correct diagnosis only after passing the appropriate laboratory tests, a careful examination of the medical card and a thorough examination of the patient. When making a diagnosis, it should be noted that the symptoms of septic arthritis can also occur in other diseases (rheumatic fever, gout, borreliosis, etc.).

Sometimes the doctor refers the patient to an additional consultation with a rheumatologist and orthopedic surgeon in order to avoid a false diagnosis.

To confirm the diagnosis, the doctor prescribes the following types of studies:

  • puncture of the joint for a detailed study of synovial fluid,
  • biopsy and seeding of the synovial tissue around the joint,
  • urine and blood cultures, as well as mucus from the cervix, etc.

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

Treatment of infectious arthritis

As a rule, in case of infectious arthritis, patients are treated for some time permanently, prescribing medication and physiotherapy sessions for several weeks or months.

If the disease is detected at a late stage and threatens with serious violations, the doctors immediately begin intravenous administration of antibiotics. And after identifying the causative agent, the doctor prescribes adequate treatment of infectious arthritis.

For viral infections, nonsteroidal anti-inflammatory drugs are prescribed. The course of therapy with intravenous antibiotics is up to two weeks, after which the patient is prescribed a long course of oral antibiotics.

The entire period of inpatient treatment of the patient is under the vigilant supervision of doctors. A patient takes a synovial fluid daily for analysis. This allows you to determine the effectiveness of treatment. Since infectious arthritis is often accompanied by strong painful sensations, painkillers are prescribed to the patient. To protect the joints from accidental and sudden movements, the patient may impose a splint.

In some cases, surgery is used to treat infectious arthritis. It is used for those patients for whom antibiotic therapy is not effective, or for serious lesions of the hip or other joints, from which it is problematic to take a puncture. Surgical treatment is also preferable in cases when infectious arthritis is caused by a penetrating or gunshot wound.

If the patient has already experienced severe damage to the cartilage and bone, reconstructive surgery may be used. However, an operation can be performed only when the infection has completely disappeared from the body.

After discharge from the hospital, the patient is recommended to perform a special set of physical exercises that promote faster recovery.

Prognosis of infectious arthritis

The favorable outcome of the disease depends largely on how quickly adequate treatment of infectious arthritis was initiated. It should be noted that in about 70% of cases, patients manage to avoid irreversible destruction of the joints, but many patients develop complications such as partial deformity of the joints and osteoarthritis. In children with septic arthritis of the hip joint, a violation of the bone growth zone often occurs. The most common causes of death are respiratory failure and septic shock.

What is infectious arthritis?

Infectious arthritis (septic arthritis) is an inflammation of the joints caused by a microbe. Most often it is a bacterium, but it can also be a virus or a fungus.

Damage to the joints usually occurs as a result of an infection that has occurred in other parts of the body.

In general, only one joint is affected, but sometimes the disease affects two or three. Infection most often occurs in large joints (shoulders, hips, knees), but can also occur in smaller joints (fingers, ankles).

What are the risk factors for infectious arthritis?

In infectious arthritis, a microbe that has entered the body through the skin, nose, throat, ears, or wound is transferred to the joint.

As a rule, the infection first appears in another part of the body. For example, if infectious arthritis is caused by pneumococcus, the bacterium responsible for pneumonia, the infection could occur primarily in the lungs. After the initial infection, the microbe can enter the bloodstream, then into the joint, colonize it and cause inflammation.

Most cases of infectious arthritis are of bacterial origin. Different types of bacteria can cause infectious arthritis, including:

  • gonorrhea,
  • Staphylococcus,
  • streptococcus,
  • Pneumococcus,
  • hemophilic,
  • spirochetes,
  • Mycobacterium tuberculosis.

Infectious arthritis can also be caused by the following viral infections:

Fungus is the least common cause of infectious arthritis. Responsible fungi are usually present:

  • in the ground
  • in bird droppings,
  • on some plants, including rose bushes.

Septic arthritis is not transmitted, but some microbes (for example, those responsible for gonorrhea) can be transmitted through personal contact. However, even if these diseases are transmitted, infectious arthritis does not develop systematically in people who become infected with them.

Is infectious arthritis spread?

While infectious arthritis affects people of all ages, the risk of it occurring is higher in some people, including people with a condition that reduces the body’s ability to fight infections, for example:

  • diabetes,
  • sickle cell anemia (or hemoglobinopathy),
  • severe kidney disease
  • acquired immunodeficiency syndrome (AIDS), developing on the background of HIV infection,
  • immunodeficiency,
  • certain forms of cancer
  • alcoholism,
  • intravenous addiction.

The risk of developing infectious arthritis is higher in people who already have arthritis, because microbes often affect the sore and weakened joints than the healthy joints. When replacing a joint with a prosthesis (arthroplasty), there is also a low risk of infection of the joints. If this type of infection usually occurs soon after surgery, it can also occur months or years later.

In addition, some of the powerful drugs used to treat inflammatory forms of arthritis can reduce the body's resistance to infections and contribute to the development of infectious arthritis.

On the other hand, the risk of infectious arthritis is higher in people who, in their work, are often exposed to animals, plants, marine organisms or the earth.

Signs of Infectious Arthritis

Symptoms vary according to the type of germ causing infectious arthritis. When arthritis is caused by a bacterium, inflammation is usually limited to one area, and the infection is often accompanied by fever, chills and appears relatively suddenly.

When it comes to viruses, the infection usually does not cause a fever, but causes widespread the discomfort. When it comes to a fungus, inflammation can be local or generalized, it usually takes weeks, if not months, to show the first symptoms (see photo below), which are sometimes accompanied only by low temperature.

How is infectious arthritis diagnosed?

Making an accurate diagnosis is an important step before treating infectious arthritis. If your doctor thinks that you have infectious arthritis, you will be asked a lot of questions to get the full picture: symptoms, other diseases, recent trips, diseases, contacts with people who may be carriers of infections.

You can also undergo a medical examination, X-rays and other tests to detect the germs that cause the infection. For example, a sample of articular fluid can be taken with a syringe for analysis.

If the suspected primary cause of arthritis is, for example, pulmonary tuberculosis or a fungal infection, you can take a small sample of articular tissue (a procedure called a biopsy) for examination in a laboratory. On the other hand, if there is a suspicion of a viral infection, you will be asked to donate blood for analysis in order to detect antibodies produced by your body to fight the virus.

Pharmaceuticals

Arthritis drugs are aimed at controlling the disease, slowing its progression and protecting the joint. In cases of infectious arthritis, the best results are achieved when treatment begins immediately, and an appropriate antibiotic is used for this type of infection.

For the treatment of septic arthritis, many drugs are used, from painkillers to steroids, but the main anti-bacterial therapy started in time. The following antibiotics are mainly used:

  • Benzylpenicillin sodium salt or Ceftriaxone (against gonococci, meningococci),
  • Cefalotin, Vancomycin, Clindamycin, Naftsilin (Staphylococcus),
  • Benzylpenicillin Sodium Salt and Vancomycin (Streptococcus),
  • Gentamicin and, for example, Ampicillin or Zeporin (gram-negative bacteria),
  • Chloramphenicol + Levomitsetin (microorganisms of the genus Haemophilus).

Painkillers (analgesics):

The optimal treatment is case-by-case, so discuss the medicines that are best for you with your doctor or pharmacist.

Additional treatment methods

In cases where diagnosis and treatment are delayed, and infectious arthritis causes joint damage, a person with this disease may need additional help to restore mobility and quality of life after infection. The following medical personnel received in-depth academic training and received a license from their provincial or territorial associations to practice their profession.

Physiotherapists can develop an individual program designed to increase the strength, flexibility, mobility and tolerance to the physical load of the joint with the help of various treatment methods and therapeutic strategies. It may include the appointment of exercises, physical intervention and recuperation.

Physical therapists may also recommend other methods to reduce pain and improve the overall quality of life. They can also refer their patients to other health care providers and to a local rehabilitation center for additional measures to adapt to changing living conditions.

Ergotherapists Those trained to treat arthritis can also analyze everything you do during the day and develop a program to help you protect your joints and reduce fatigue. They can also help you reorganize your home environment or workplace, if necessary, to facilitate work and movement.

They can also recommend orthopedic tires, appliances, orthopedic shoes, and other devices that can help reduce pain and increase your mobility and ability to work. Their goal is to prepare you for a new life using assistive devices and strategies.

Prevention and recommendations

Prevention includes preventing contact with potential infections. In addition, if you have symptoms that indicate infectious arthritis, consult a doctor immediately.

If a long time elapses between the occurrence of an infection, diagnosis, and treatment, it can damage your joints, which will affect your mobility and quality of life. However, there are some measures you can take to improve the quality of life for this disease.

Although you can perform many of these methods yourself, it is advisable to have a medical team that will help monitor and direct your prevention efforts.

Exercises

People with infectious arthritis often experience muscle weakness around the affected joint after treatment. Exercise is important for restoring these muscles to normal.

Exercise is a physical activity that includes constant repetitive efforts designed to improve or maintain physical fitness.

Weight lifting, running, yoga is a type of planned activity that needs to be done in order to improve flexibility, strength or endurance. Physical activity will help reduce pain and fatigue, improve mobility, overall fitness and mood, allowing you to take a concrete part in your treatment.

Relaxation methods and adaptation strategies

Applying effective relaxation techniques and adaptation strategies can help you lead a balanced lifestyle, better control your septic arthritis and inspire optimism.

There are many ways to relax. Examples include deep breathing exercises, listening to music or relaxation recordings, or mental visualization of pleasant and relaxing activities, such as relaxing on the beach.

Arthritis of the knee

The lesion of the knee joints of an infectious nature is called chases. The disease can develop suddenly and proceed very quickly with pronounced symptoms or be chronic with a long course and severe exacerbations. Signs of bacterial gonita vary depending on the stage:

  • The first stage is characterized by fever, general weakness chills. The patient may feel pain when moving (bending / straightening the knees) and stiffness in the morning.
  • In the second stage, the lesion of the articular part of the cartilage begins. Fluid (effusion) accumulates in the knee, while palpation of the limb or tapping on the joint, the patella is running (slightly shifting or oscillating in different directions). The patient feels a sharp pain.
  • The third stage is characterized by the appearance of a persistent violation of the functionality of the knee joint. The patient cannot independently bend or unbend a leg, and the help from the outside causes a sharp pain. In this case, the extremity looks very swollen, there are reddening of the skin. Often the third stage leads to disability.

Hip joint

Inflammation of the hip cartilage or coxitis is more commonly diagnosed in elderly patients, although it can sometimes occur in infants. When feeling the thigh, the patient feels a sharp pain, discomfort is reflected in the heel. Coxite tends to progress rapidly. Without proper treatment, the disease develops to the third stage in 1-2 days, often provoking sepsis. Typical symptoms of infectious arthritis in the hip part of the body:

  • sharp pains that extend beyond the joint - on the thigh, knees, buttocks, feet, groin,
  • stiffness, difficulty moving limbs,
  • swelling of the soft tissues of the joint, which may extend to the groin, abdomen, buttocks, knees, thighs,
  • general deterioration of health - chills, fever, lethargy.

Ankle joint

In bacterial arthritis of the ankle, pain is noted both during active movements of the limb and at rest. The patient is difficult to walk, step or lean on the leg. Formed the forced position of the foot - back side out. Other characteristic symptoms:

  • swelling of the leg, when pressing on the swelling remains a depression from the finger,
  • skin flushing, sensation of heat at the site of injury,
  • deterioration of general condition - drowsiness, lethargy, increase in body temperature, muscle pain.

Acute infectious arthritis

By the nature of the course of the disease is divided into acute and chronic forms. Rapidly developing arthritis is serous, serous-fibrous and purulent. The last form is the hardest. Regardless of the location and causes of origin, all acute arthritis is characterized by the presence of the following symptoms:

  • A sharp increase in body temperature to the level of 39 degrees. In this case, the patient often has chills, sweating, and weakness.
  • Pain in limbs. At the initial stage, the pain syndrome often has a paroxysmal migratory character and can occur in several small joints at once.
  • Changing the functionality of the articular part. Above the affected area, edema often appears, which makes it difficult to flex the limb, and the skin becomes hot to the touch. With the progression of the disease, destruction of cartilage and bone tissue occurs.
  • Intoxication of the whole body. Patients complain of fatigue, weakness, sweating. There may be nausea and vomiting at high temperatures. The skin of the face is pale, often cause headaches, dizziness, decreased or no appetite.

Purulent or pyogenic arthritis develops on large joints, and without proper treatment can lead to the development of sepsis or symptoms of infectious-toxic shock:

  • increase in body temperature over 39 degrees
  • confusion and speech
  • loss of consciousness,
  • rave,
  • heart palpitations
  • pale, bluish skin,
  • renal, hepatic, cardiac, respiratory failure,
  • drop in blood pressure.

Chronic course

Sometimes infectious type arthritis becomes chronic. This is characteristic of diseases caused by mycoplasmas, chlamydia, tubercle bacillus, various strains of the fungus. In the tuberculous form, there is a specific symptom - pale skin over the inflamed joint. With a long course on the affected area appear fistula, which burst with the release of thick pus. Common symptoms for the chronic form of arthritis are:

  • temporary increase in subfebrile body temperature to 37.5-38 degrees,
  • mild pain syndrome
  • weak puffiness of soft tissues
  • tendon inflammation
  • limitation of the motor function of the limb, especially after a long static position,
  • general weakness
  • reduced performance
  • fast fatiguability,
  • loss of appetite
  • sweating
  • drowsiness.

Medicamentous

Priority medical measures are aimed at relieving pain, removing puffiness and lowering body temperature. For these purposes, analgesics and nonsteroidal agents with anti-inflammatory, analgesic and antipyretic effects are prescribed:

  • Analgin,
  • Ibuprofen
  • Paracetamol,
  • Nimesil,
  • Capsaicin,
  • Celebrex,
  • Nimesulide,
  • Acetylsalicylic acid,
  • Ketorol.

Antibiotics and antibacterial drugs, antiviral and antifungal agents are prescribed after determining the type of pathogen. The drugs are injected intravenously or directly into the articular cavity, before this, after the operation of pumping out the pus - drainage. After the disappearance of the acute symptoms, the medicines are taken orally. The drugs of choice include:

  • Amoxiclav - a drug from the group of penicillins, has good anti-inflammatory and antibacterial properties. The antibiotic is effective against staphylococci, streptococci, hemophilus bacilli, other gram-positive and negative bacteria. The drug is well tolerated by patients, often used in pediatric practice. The dosage is chosen based on the patient's age, the form of release of Amoxiclav and the severity of the disease.
  • Sumamed is a drug from the group of macrolides with a large number of positive reviews, has a wide spectrum of antimicrobial action. The standard daily dosage for adults is 1 capsule per day one hour before meals. Children are prescribed the drug in the form of a suspension of 10 mg per 1 kg of body weight 1 time per day. The drug rarely causes side effects, is contraindicated only in severe liver or kidney diseases.
  • Ceftriaxone, Cefepime - cephalosporins, are available as powders for solution preparation. They have a wide spectrum of action, are active in relation to the majority of gram-positive aerobic and anaerobic bacteria. The dosage and duration of use of medicines selects a doctor.
  • Gentamicin is a bactericidal antibiotic from the group of aminoglycosides, effective against most gram-positive and gram-negative bacteria. The drug is available as a powder for parenteral administration or for external use in the form of compresses. The drug has multiple contraindications, can provoke the development of various side effects from all body systems. Dosing regimen set individually, taking into account the severity of the disease.
  • Benzylpenicillin sodium salt, Vancomycin drugs are prescribed for infection with streptococci, staphylococci, some anaerobic bacteria. Medicines are available as a powder to prepare a solution for intravenous administration. Can cause various side effects, among which are frequent allergic reactions, phlebitis, nausea. Strongly contraindicated in pregnancy, kidney failure, hearing loss.

Surgical

To eliminate effusion do emergency drainage of the joint, ensuring the outflow of excess fluid through the tube. In the absence of effect, or in the case of the development of purulent sepsis, an autopsy of the periarticular cavity is performed. During this operation, the affected tissue is excised. If the infection is due to endoprosthetics, the prosthesis is removed. Surgical intervention is used only in very severe cases, in the formation of pronounced arthrosis. Applied surgical methods of treatment:

  • Arthroscopy is a procedure for removing bone processes through a micro incision. The advantage of this method over open surgery is that the joint does not fully open, which reduces the postoperative recovery process.
  • Arthrodesis is a surgical operation, the purpose of which is to completely immobilize the affected joint. This technique is resorted to in extreme cases when other methods of treatment of arthrosis have not brought results.
  • Artrolysis is an operation to remove damaged meniscus tissue and cartilage. The procedure is performed more often on the knees or elbows, and lasts no longer than 20 minutes. The advantage of arthrolysis is that the technique helps to put patients on their feet even with neglected post-infectious arthrosis.
  • Synovectomy is a procedure that involves the complete or partial removal of the synovial membrane through micro punctures. As a result of the operation, the inflammatory process is completely eliminated, the pain goes away, the limb mobility increases.
  • Osteotomy is an artificial fracture of the leg, followed by the installation of a special plate. After the procedure, the motor function of the limb is fully restored.
  • Resection - partial or complete excision of the articular ends of the bones together with the synovial membrane and cartilage. The procedure, like arthrodesis, is prescribed in exceptional cases.

Folk remedies

As an aid, along with the use of medications, folk recipes can be applied. Well relieve pain, inflammation, partially restore the mobility of limbs compresses of salt, turpentine or vodka. The following recipe is popular:

  1. Take 2 tablespoons of coarse salt, 1 tbsp. l mustard powder and kerosene.
  2. Mix all ingredients to a thick, light consistency.
  3. Apply the mixture to the affected area of ​​the body, cover with cling film, wrap a warm blanket or a scarf.
  4. Leave a compress for 1-2 hours, wash off the remnants of warm water.
  5. Apply the mixture can be no more than 1 time per day, a course of up to 1-2 months.

Compress calcium deficiency, strengthen the immune system and reduce inflammation will help herbal tinctures. Well proven alcohol-free infusion of lingonberry leaves:

  1. Measure out 1 tbsp. l dry lingonberry leaves.
  2. Grind the ingredient with a mortar and pestle.
  3. Fill the leaves with a glass of boiling water, cover with a lid.
  4. Insist the decoction in a water bath for 25 minutes.
  5. Cool the finished drink, strain.
  6. Take an inside of 1 tbsp. l before meals 3 times a day.
  7. The duration of treatment is 1-1.5 months.

Consequences and complications

In case of timely treatment, the prognosis for children and adults is favorable. In 70% of cases, there is a complete restoration of the functionality of the limbs and remission. Death is possible only in highly weakened patients of retirement age. Arthritis of an infectious nature in children without proper treatment can provoke various negative consequences:

  • destruction of the articular part of varying severity - from minimal damage to complete deformation of the bone or cartilage,
  • transition of infection to the next healthy tissue, bone, skin,
  • development of sepsis, osteomyelitis, phlegmon,
  • growth disorder of the limbs, which manifests as the child grows,
  • infectious toxic shock,
  • disability,
  • multiple organ failure.

Preventive measures

Disease prevention in healthy patients is reduced to the prevention of infection of body tissues. To do this, you must observe the following rules:

  • In the presence of at least one of the risk factors for arthritis, regularly undergo a medical examination, take tests, get vaccinations, X-rays.
  • Try not to start any infectious diseases, undergo treatment in time.
  • Strengthen immunity with the help of proper nutrition, healthy lifestyle (give up alcohol, tobacco), physical activity.
  • Avoid promiscuous sex. Engage in sexual contact only with the use of a condom.

General information

Infectious arthritis is a group of arthritis caused by infectious pathogens (viruses, bacteria, fungi, protozoa) that penetrate directly into the tissue of the joint. In rheumatology and traumatology, arthritis associated with infection is diagnosed in every third case. Infectious arthritis often affects the joints of the lower extremities, experiencing a large weight load (knee, hip, ankle), as well as the joints of the hands. Infectious arthritis is registered in representatives of various age groups: newborns, children of preschool and school age, adults.

According to the etiological principle, infectious arthritis is divided into bacterial, viral, fungal, parasitic. Given the nosological affiliation, there are septic (pyogenic, purulent), gonorrheal, tuberculosis, syphilitic, brucellosis, and other types of arthritis. Due to the nature of occurrence in a separate group, post-traumatic arthritis is distinguished.

When infection in the articular tissues from the outside speak of primary arthritis. If an infection spreads to the joint, surrounding arthritis or distant purulent foci develops secondary arthritis. The course of infectious arthritis can be acute, subacute and chronic. Damage to the joints can occur as mono-, oligo-or polyarthritis.

Most often, in case of infectious arthritis, there is a metastatic pathway of joint damage, i.e., penetration of the infection into the joint cavity by hematogenous or lymphogenous means, as a result of which the causative agent of the disease can be detected in synovial fluid.A direct route of infection is also possible, for example, with open wounds and injuries of the joint, as well as dissemination of microorganisms from closely located osteomyelitis foci.

In newborns and young children, bacterial arthritis is more often caused by staphylococcus, enterobacteria, hemolytic streptococcus, and hemophilic bacilli. In adult patients, along with aerobes, the common causative agents of infectious arthritis are anaerobic microorganisms: peptostreptokokki, fusobacteria, clostridia, bacteroids. Acute bacterial arthritis can occur against a background of sore throat, sinusitis, pneumonia, furunculosis, pyelonephritis, infective endocarditis, sepsis. In addition, there are specific infectious arthritis due to tuberculosis, syphilis, gonorrhea, etc.

Fungal arthritis is usually associated with actinomycosis, aspergillosis, blastomycosis, candidiasis. Parasitic arthritis is usually associated with helminthic and protozoal invasions. Viral arthritis occurs with rubella, mumps, viral hepatitis B and C, infectious mononucleosis, etc. Post-traumatic infectious arthritis in most cases develops due to penetrating joint injuries. Iatrogenic infection during the treatment and diagnostic puncture of the joint, intra-articular injections, arthroscopy or endoprosthesis replacement is not excluded.

The category of persons with an increased risk of developing infectious arthritis includes patients suffering from rheumatoid arthritis, osteoarthritis, STIs, alcohol or drug addiction, immunodeficiency states, diabetes, obesity, vitamin deficiencies, experiencing significant physical (including sports) stress and etc.

Prognosis and prevention

One-third of patients who have had infectious arthritis have residual effects in the form of limited mobility of joints, contractures, and ankylosis. Septic arthritis is a serious threat: in spite of the possibilities of therapeutic and surgical treatment, mortality in a complicated course reaches 5-15%. Among the adverse prognostic factors are rheumatoid arthritis, septicemia, old age, immunodeficiency states. Arthritis prevention includes timely treatment of common infectious diseases, adequate physical exertion, prevention of joint injuries, protection against STIs, compliance with the requirements of asepsis and antisepsis during surgical procedures.

Causes of illness

The main root cause, which provokes infectious arthritis, is considered to be the penetration of a pathogen into the body, which can be infected by injury and contact with a sick person. An inflammatory reaction occurs in the joint in response to a stimulus. Often the disease is accompanied by the accumulation of purulent exudate. In this case, developing septic arthritis, which may be accompanied by sepsis.

The addition of a bacterial infection provokes inflammation.

There are a number of factors that cause inflammation in the joint cavity:

  • defeat by bacteria (streptococcus, staphylococcus, gonococcus),
  • viral pathologies (HIV, hepatitis, rubella),
  • parasitic infection
  • fungi,
  • wounds and injuries with damage to the skin,
  • associated diseases (pneumonia, tonsillitis, cystitis, tuberculosis, gonorrhea, syphilis).

Still, the risk of developing an infectious form of arthritis increases in people suffering from obesity and diabetes. Tumor neoplasms, anemia and avitaminosis also contribute to the pathological condition. At risk are people suffering from alcohol and drug addiction.

Mostly infectious arthritis in children causes staphylococcus and hemolytic streptococci, which is characterized by acute onset and severe illness.

Types of pathology

Separate primary and secondary arthritis. The first occurs with the direct penetration of the pathogen into the articular cavity. The second variant of inflammation of the joints develops on the background of infection of closely lying soft tissues. Also, the pathology is classified according to the nature of the root cause, which provoked an inflammatory reaction in the diseased articular joint.

Fungal subspecies

Fungal infections rarely affect bone and cartilage tissue. Inflammation of the articular articulation is secondary, when the pathogens spread from the closely lying bone center or when the whole body is infected. Fungal arthritis is treatable. With the timely start of therapy completely passes. In advanced cases, fungal arthritis becomes chronic.

Parasitic subspecies

More often, parasitic arthritis occurs against diseases such as teniasis, filariasis and dracunculiasis. Inflammation is provoked by both the parasites themselves and their eggs. The danger is that the carrier of the parasite is contagious and, if the household and hygiene rules are not followed, it can trigger the spread of the pathogen. Mostly suffer small articular joints, which is accompanied by a rash on the skin.

Bacterial subtype

Bacteria that cause a pathological condition, penetrate into the articular cavity, with the activity of concomitant disease. Most children suffer from bacterial arthritis, as well as the elderly. In babies, staphylococcus aureus pathogen becomes the primary cause of the pathology. Older people have streptococcal arthritis.

Bacteria that infect a joint penetrate its cavity through blood flow. Often the cause of the development of arthritic lesions lies in the aggressiveness of genitourinary pathology or venereal diseases. In this case, focal lesion is noted in the joints of the hands, elbow, ankle, and also in the knee joint.

Staphylococcal subspecies

The presence of infections provokes a purulent process that destroys the structure of the joint. Staphylococcal arthritis is accompanied by rapid destruction of cartilage tissue. Symptoms of pathology are pronounced and begin acutely. An aggressive infection destroys both the body of the joint and its synovial membrane. The pathogen enters the junction through the lymphatic and blood flow, as well as due to the development of osteomyelitis.

Virus subtype

Infectious lesion of the joints, which accompanies viral arthritis, occurs against the background of the main disease. The first symptoms occur 4-5 days after the pathogen enters the body. Initially, viral arthritis affects the joints of the upper limbs, especially the hands and fingers. Destructive pathology extends to the joints of the lower extremities, which leads to severe pain when walking. Inflammation of the articular joints is noted against the background of the following ailments:

Rheumatoid subtype

Pathologies such as infectious arthritis can provoke dysfunction of the immune system. The development of an autoimmune reaction leads to the formation of a rheumatoid disease. Often, rheumatoid arthritis causes inflammation of several joints. Pathology is rarely served to complete cure, which causes disability. It can provoke a number of complications, which include infectious arthrosis and osteoarthritis.

Reactive subtype

Post-infectious arthritis occurs as a reaction to pathogenic bodies that penetrate the joint cavity in infectious pathologies of the gastrointestinal tract and the genitourinary system. In the articular articulation enters through the bloodstream. Reactive arthritis manifests itself several months after the development of the main disease. Most often affects the joints of the lower extremities.

Main symptoms

The symptomatology that accompanies infectious arthritis depends on the location of the site of inflammation. More often suffer large joints, namely:

  • Knee. In general, infectious arthritis of the knee joint is accompanied by severe pain, thus complicating the process of flexion and extension of the articulation. The exudate accumulates (effusion), which, on palpation, moves along the articular cavity.
  • Hip. Sharp pains are prone to irradiation to the thigh, buttock and groin. Violated gait. There is swelling of the tissue that extends to the groin and abdomen. Often leads to the development of sepsis.
  • Ankle. There are pains when performing any movement and the development of contracture.

For the acute onset of the ailment, the following symptoms are characteristic: intense pain, fever, edema and hyperemia of tissues, impaired mobility. As well as signs of intoxication in the form of weakness, drowsiness and loss of appetite. Children get nausea and vomiting. Chronic form is accompanied by subfebrile condition, moderate pain, slight swelling and mild intoxication.

How is the treatment?

Initially, therapy is aimed at eliminating the root causes of the development of pathology. Prescribed treatment with antibiotics, antifungal agents ("Nystatin") and antibiotic therapy ("Tseporin", "Ampicillin"), depending on the nature of the pathogen. Nonsteroidal anti-inflammatory drugs (Nimesil, Ibuprofen, Nurofen) and analgesics (Tylenol, Paracetamol) are used to relieve pain. In order to reduce inflammation, steroid hormonal preparations are prescribed, which include “Hydrocortisone” and “Detralex”. To restore the structure of cartilage using chondroprotectors, ("Glucosamine" or "Struktum").

In severe cases, the treatment of infectious arthritis requires surgery to remove inflamed tissue.

Arthritis can be treated with the help of physiotherapeutic procedures that have an analgesic and anti-inflammatory effect. For this purpose, use: drug electrophoresis, magnetic therapy, phonophoresis, ultrasound and laser therapy, as well as mud applications. To improve blood circulation and restore normal mobility of the joints apply exercise therapy. Use folk remedies. Apply warming compresses and ointments on the basis of honey and badger fat.

Prevention and prognosis

Often, after curing arthritis, the remaining contracture is noted with impaired mobility of the articulation. A major threat is the septic form, which, despite the complexity of treatment, can be fatal. The rheumatoid form of the pathology becomes chronic with periodic remissions. Prevention consists in timely treatment of viral and infectious diseases, moderate physical activity and good nutrition. It is important to follow the rules of hygiene and sterility of the operational manipulations.

Do you still think that it is impossible to cure the joints?

Judging by the fact that you are reading these lines now - the victory in the fight against cartilage tissue inflammation is not on your side yet.

And you already thought about inpatient treatment? This is understandable, because pain in the joints is a very dangerous simtom that, if not treated promptly, may result in limited mobility. Suspicious crunch, stiffness after a night of rest, the skin around the problem area is stretched, swelling in a sore spot. All these symptoms are familiar to you firsthand.

But perhaps it is more correct to treat not the effect, but the cause? We recommend reading the article on modern methods of treatment of joints. Read the article >>

Watch the video: Orthopedics: Septic Arthritis in Children (December 2019).

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