Infective Arthritis

Infectious arthritis, also known as septic arthritis, is a serious condition characterized by a sudden and severe infection in one or more joints. This infection rapidly inflames the joint lining (synovium) and the synovial fluid, which lubricates the joint and nourishes the surrounding tissues.

If left untreated, infective arthritis can cause significant joint damage, including erosion of cartilage and bone, and even permanent disability. Early diagnosis and prompt treatment are crucial to prevent these complications.

Causes

Infective arthritis can be caused by various germs, including:

• Bacteria: The most common culprit, particularly Staphylococcus aureus (staph) which commonly lives on the skin.
• Viruses: Less frequent than bacterial infections, but some viruses, like mumps or hepatitis B, can infect joints.
• Fungi: Rare cause, but fungal infections can occur in immunocompromised individuals.

The germs can reach the joint through different pathways:

• Bloodstream infection: An infection elsewhere in the body, like a skin infection or urinary tract infection, can spread through the bloodstream and settle in a joint.
• Direct penetration: A puncture wound, injection site, or surgery near a joint can create an opening for germs to enter directly.

Symptoms

The symptoms of infective arthritis typically develop suddenly and worsen rapidly. They can include:

• Severe pain: The affected joint will be extremely painful, often described as a throbbing or constant ache. Even slight movement can be excruciating.
• Swelling: The joint will become noticeably swollen and inflamed.
• Warmth: The infected joint may feel warm to the touch.
• Redness: The skin around the joint may appear red and flushed.
• Limited movement: The pain and swelling can significantly restrict movement of the affected joint.
• Fever: A fever is a common symptom, especially in children.
• Chills: You may experience chills along with the fever.
• Malaise: A general feeling of illness and fatigue can accompany the infection.

In some cases, additional symptoms may be present depending on the cause of the infection.

Diagnosis

Prompt diagnosis is critical to prevent joint damage. A doctor will typically perform a physical examination to assess the joint pain, swelling, and range of motion. Diagnostic tests may include:

• Joint fluid aspiration: A needle is inserted into the joint to extract a sample of fluid. This fluid is then analyzed to identify the specific germ causing the infection.
• Blood tests: Blood tests can help identify signs of infection and inflammation in the body.
• Imaging tests: X-rays or MRI scans may be used to assess for joint damage.

Treatment

Infective arthritis requires immediate medical attention. Treatment typically involves a combination of antibiotics and other medications:

• Antibiotics: Once the germ is identified through the joint fluid analysis, doctors will prescribe specific antibiotics to target the infection. Early and appropriate antibiotic treatment is crucial for a successful outcome.
• Pain medication: Pain relievers, such as ibuprofen or acetaminophen, can help manage the pain and inflammation.
• Joint immobilization: In some cases, the doctor may recommend splinting or bracing the joint to allow for rest and healing.
• Physical therapy: After the infection resolves, physical therapy can help regain strength, flexibility, and range of motion in the affected joint.
• Minimally Invasive Procedure: Image-guided joint injections can be utilized to accurately administer medications, including antibiotics and corticosteroids, directly into the infected joint, facilitating faster recovery and pain relief (Click here to read more on Ultrasound guided joint / soft tissue injections).
  
   

Prevention

Several measures can help reduce the risk of infective arthritis:

• Maintain good hygiene: Regular handwashing is essential to prevent the spread of germs.
• Practice safe skin care: Properly clean and disinfect any wounds or cuts to prevent infection.
• Seek prompt medical attention: Don’t ignore any signs of infection, such as skin infections or urinary tract infections. Early treatment can help prevent the spread of infection to the joints.
• Joint injection safety: Ensure proper sterile techniques are followed during joint injections.