Show Notes
Episode Produced by Audrey Bree Tse, MD
Background
Bacteria enters the joint by hematogenous spread due to absence of basement membrane in synovial space from invasive procedures, contiguous infection (e.g. osteomyelitis, cellulitis), or direct inoculation (e.g. plant thorns, nails)
WBCs migrate into joint → acute inflammatory process → synovial hyperplasia, prevents new cartilage from forming, pressure necrosis on surrounding joint, purulent effusion
Why do we care?
irreversible loss of function in up to 10% & mortality rate as high as 11%
Cartilage destruction can occur in a matter of hours
Complications include bacteremia, sepsis, and endocarditis
Etiology
Risk factors: extremes of age, RA, DJD, IVDA, endocarditis, GC, immunosuppression, trauma, or prosthesis
Organisms:
Staph: staph aureus (most common), MRSA, Staph epidermis