Possible alternative to diagnosis include gout, arthritis, trauma, certain tumours, a foreign body, and several other possible causes of non-infective Joint Pain. There several possible mechanisms for an infection to develop in a joint:
The most common organism involved with joint sepsis in all age groups is Staphylococcus Aureus, but some organisms tend to prefer certain population groups. For example, neonates seem to develop Streptococcus infections; children 6 months to 5 years have a higher occurrence of Hemophilus Influenza; teens tend to develop Neisseria infections more than other groups; Pseudomonas tends to be common with puncture wounds; Salmonella is common in those with sickle-cell disease; and the patient with diminished immunity (AIDS patients, IV drug users, those taking steroids, those undergoing chemotherapy) have a higher incidence of Serratia. Laboratory blood work (ESR, CRP, WBC, blood cultures, e.g.) can be helpful in diagnosing joint sepsis, as can imaging techniques like traditional bone scans and seratec scans, as well as MRI and CT, but one of the most accurate and quickest methods is joint aspiration, (also known as arthrocentesis), where joint fluid is analyzed after being withdrawn from the joint by a needle. In the presence of an infection, the fluid tends to become cloudy and has a much higher-than-normal number of white blood cells. Another method to help diagnose joint sepsis and assess its extent is also a treatment--surgical intervention to open up, drain and test a joint for infection may be the best way to visualize the damage to a joint caused by joint sepsis. Though critics of this technique correctly point out that the surgery, itself, may cause scar tissue and joint damage, sometimes there is no other option. Surgery may often be required to fully resolve the joint infection, and delaying such surgery can result in the complete destruction of the joint from sepsis. Such surgery is usually combined with PMMA beads, IV and/or oral antibiotics.
|
|