Purulent arthritis of joints: causes, symptoms, treatment
Purulent arthritis is an inflammatory process in joint tissues, the development of which is promoted by pathogenic microorganisms, mainly coccal flora. According to statistics, the most common cause of the disease is staphylococcal infection. It is found in 80% of patients. The remaining 20% is joint damage caused by:
- with Pseudomonas aeruginosa.
Purulent arthritis is found not only in adults, among the sick there are many children, and the diagnosis in such cases is complicated by the inability to identify the causative agent of the infection.
The inflammatory process can develop as a result of the following factors:
- surgical interventions;
- breakthrough of a purulent focus in surrounding tissues;
- penetration of bacteria from distant sources of infection.
Purulent arthritis of the knee often becomes one of the symptoms of a general infection of the blood. This is a life-threatening condition especially occurs in children of the first year of life. The rate of development of the disease, the severity of its symptoms and the risk of complications depends on the general condition of the organism and the type of pathogen. If there is a focus of purulent infection, the launch of a pathological process can be facilitated by any trauma associated with damage to the joint tissues. It is the falls and traumas that occur during the training of walking, are the main reasons for the development of purulent arthritis of the ankle in children.
How does this disease manifest itself?
The pathological process is marked by an acute onset with a significant deterioration in the general condition. Inflammation covers 1 to 2 joints, most often knee or elbow. Purulent arthritis of the hip joint is less often diagnosed. Thus, out of 100 children affected by a knee joint injury, 70 suffer, and the hip joint - 17.
Arthritis of TBS is most often found in the smallest patients.
As a result of the allocation and accumulation of inflammatory fluid in the joint cavity, its deformation occurs. Sometimes pathological changes can be manifested by the destruction of the epiphyses. The local temperature rises, the skin turns red and becomes tense. Ankle with arthritis ankle swells and becomes immovable. There is a sharp pain, which increases with movement. Reducing the intensity of unpleasant sensations helps fixing the joint in a certain position, with arthritis of the hip joint, the leg is bent and pressed against the body.
Diagnosis of purulent arthritis
The detection of the disease begins with a general blood test and radiology examination of the joint. In the early stages of an X-ray, obvious abnormalities may not be detected, but with time the following diagnostic symptoms appear:
- thickening of the walls of the joint bag;
- decreased bone density;
- destruction of cartilaginous tissue;
- disappearance of the joint space.
The total blood count reflects an increase in ESR, anemia and mild leukocytosis. Pus, located in the joint cavity, is taken for examination by puncture.
In recent times, sepsis has been accompanied by the appearance of foci of infection in the bones and joints. They were found in 20% of young children who died of sepsis. At present, the number of cases of metastatic damage, as well as the infection of blood, has significantly decreased. The presence of foci of infection in the bones aggravates the severity of the course of purulent arthritis. Especially dangerous is the purulent lesion of the hip joint, which is associated with the difficulties of detection and the possibility of developing dangerous complications. Symptoms of arthritis in newborns suffering from sepsis may recede into the background. And doctors do not attach importance to the special position of legs, considering it normal for a child of this age.
Therefore, the diagnosis should include the examination of the joints in the process of movement and the timely performance of the puncture. It should be taken into account the fact that in children weakened by the disease, the symptoms of purulent arthritis can have a mild degree of severity. The final diagnosis is based on:
- clinical picture of purulent arthritis;
- blood test results;
- results from an investigation of an inflammatory fluid.
The basis of etiological diagnosis is the bacteriological analysis of blood and joint effusion, which can be performed several times. In some cases, the causative agent of infection is not possible, despite the presence of pronounced symptoms. In such situations it is necessary to exclude other forms of arthritis, characterized by the accumulation of effusion in the synovial cavity.
The sooner an accurate diagnosis is made and the treatment is started, the better the prognosis for recovery. Otherwise, the risk of osteomalacia that makes a person disabled is increased.
Methods of treatment of the disease
To get rid of the effects of purulent arthritis is possible only through surgical intervention. In the later stages of the disease, conservative treatment becomes unable to improve the joint condition. The operation is assigned and, if necessary, an urgent decompression. Medication therapy involves the use of antibacterial and anti-inflammatory drugs. During this period, the knee needs to be immobilized. The puncture is used to remove the purulent contents of the synovial cavity.
Large doses of antibiotics can be administered both intramuscularly and intravenously several times a day. Assign these drugs after determining the sensitivity of the causative agent of the infection to the active substance. This is especially important when eliminating staphylococcal infections that are resistant to most antibiotics. Arthritis of the purulent joint is successfully eliminated with semisynthetic penicillins, macrolides, cephalosporins. Treatment is more effective in the joint use of antibiotics and sulfonamides. After removing the pus and the area of the synovial cavity, topical preparations can be used.
The frequency of the puncture is determined by the rate of accumulation and the amount of effusion in the joint. Such treatment is terminated after the liquid becomes clear. During the exacerbation of the disease, intraarticular injections and physiotherapeutic procedures are contraindicated.