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Lecture notes

Acute mono-arthritis

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This document contains all the relevant student knowledge pertaining to acute mono arthritis. It includes: Differential diagnosis Symptoms Investigations Management

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Document information

  • December 18, 2022
  • 5
  • 2022/2023
  • Lecture notes
  • Caitlin austin
  • All classes

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A cute mono arthritis Acute onset of arthritis affecting a
single joint It may be a large weight bearing joint or smaller

e.g The great toe
Main causes
Sepsis
Crystals
Blood


Assess pt for
Predisposing factors for infection
Immunocompromised
IV
drug abuse
Diabetes
Recent infection
Direct penetrating wound


Infectious symptoms
Systemically unwell Fever sweats anorexia malaise THR LBP
At risk recent STI


Features suspicious of Crystals e.g Gout
Previous episodes
Pre disposing factors 7 Excess alcohol diuretic
renal impairment

, Features suspicious of haemarthrosis
Bleeding disorder
Anti coags
Trauma


Investigations
Joint aspiration Gram stain WCC culture crystals
Routine bloods WCC ESR CRP Ute LET
X USS MRI
ray
A Sepsis Septic arthritis
Either Haematogenous spread most common from
other infection e.g UTI RTI of Local spread
local tissue infection penetrating trauma
Pathogens Staph aureus Staph epidermidis N gonnorhoea

Management
IV abx Flucloxacillin t
Benzylpenicillin
6 weeks PO Fusidic acid narrow spectrum
AB X for
staph infection
IV Clindamycin in Penicillin
allergy
Regular joint aspiration lavage
Analgesia rest ICE packs
Thrombo prophylaxis

Surgical washout if failure to improve

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