Septic Arthritis: General Orders and Treatment

- Diff Dx

- Evaluation: (before antibiotics are infused):
    - synovial fluid analysis
         - culture & gram's stain;
         - leukocyte count
         - glucose and viscosity (both decreased w/ infection);
    - blood culture, CBC, CRP, & sed rate
    - radiographs (and possibly ultrasound):
         - need to rule out concomitant metaphyseal osteomyelitis;
    - misc: bone scans

- Treatment:
    - based on antimicrobial suseptabilities as well as patient age:
         - less than 3 months
         - from 6 mo to 2 yrs
         - greater than 2 yrs;
    - drainage:
         - drainage can be provided by repeated closed needle aspiration, arthroscopy, or arthrotomy;
              - septic hip demands open drainage;
              - if joint cannot be adequately drained because of loculations or if the joint is not responding clinically with gradually decreasing synovial-fluid leukocyte counts and negative cultures, open surgical drainage will be necessary

Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Thursday, November 29, 2012 3:19 pm