Infectious Arthritis In The Elderly

From Anvita Health Wiki

Contents 1 Etiology 2 Pathology 3 Clinical-manifestations 4 Laboratory 5 Radiology 6 Complications 7 Differential-diagnosis 8 Management 9 More General Terms 10 References

Etiology

• most common causative organisms

• Staphylococcus aureus
• Streptococcus
• gram negative bacilla increasing in frequency

• risk factors

• cancer
• immunosuppression
• chronic illness

• diabetes mellitus (24% of patients)
• chronic renal failure

• prosthetic joint surgeries
• chronic arthritis
• recent procedures

Pathology

• knee is most common joint

Clinical-manifestations

• frequently afebrile
• joint out of sync
• (see infectious arthritis)

Laboratory

• complete blood count - WBC is often normal on presentation
• erythrocyte sedimentation rate (ESR)

• usually elevated
• average value 79 mm/ hr

Radiology

• 71% have radiologic evidence of pre-existing joint disease

Complications

• 38% develop osteomyelitis
• 19% mortality due to sepsis

Differential-diagnosis

• sexually transmitted disease
• cellulitis
• regional sympathetic dystrophy ( RSD)
• bursitis
• osteomyelitis
• crystalline arthropathy (gout, pseudogout)

Management

• see infectious arthritis

More General Terms

• geriatrics
• infectious arthritis (septic arthritis)

References

1. Weiner S, In: UCLA Intensive Course in Geriatric Medicine & Board Review, Marina Del Ray, CA, Sept 12-15, 2001
2. National Guideline Clearinghouse The diagnosis of periprosthetic joint infections of the hip and knee. American Academy of Orthopaedic Surgeons (AAOS) ngc-guideline: [1]

infectious arthritis in the elderly