The Orthobullets Podcast Trauma⎪Septic Arthritis - Adult
Dec 6, 2019
A focused review of adult septic arthritis covering which joints are most often involved and unique risks like IV drug use. They outline the changing microbial culprits and how organisms guide classification. Discussion includes rapid cartilage damage, diagnostic approaches from aspiration to imaging, and surgical plus antibiotic treatment principles. Practical case questions highlight sternoclavicular disease, gonococcal therapy, and saline testing for knee injuries.
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Joint Frequency Pattern In Adult Septic Arthritis
- The knee is the most commonly affected joint, causing about half of adult septic arthritis cases.
- Other joints in descending frequency are hip, shoulder, elbow, ankle, and sternoclavicular, the latter often linked to IV drug use.
Staphylococcus Aureus Dominates Adult Cases
- Staphylococcus aureus is now the predominant pathogen, accounting for over 50% of adult cases.
- Historically Pseudomonas dominated in the 1980s, and other organisms (gonorrhea, gram-negatives) are important by risk group.
Rapid Cartilage Destruction Timeline
- Septic arthritis causes irreversible cartilage destruction rapidly, with cartilage injury occurring as early as eight hours.
- Damage is mediated by proteolytic enzymes released from inflammatory cells.