Also called infectious arthritis, septic arthritis is a kind of joint disease caused by bacterial infection (mostly) or other infectious causes. It leads to painful joint and other discomforts such as swelling, redness, and difficulty using the affected joint. The good news, it often relieves without causing serious after effects, though sometimes it could also turn into serious and cause serious joint damage. After treatment, can it come back months or years later?
Many joint structures such as synovial fluid (special fluid surrounding the joint) and synovium (the lining of the joint) are vulnerable to infection. Septic arthritis occurs when an infection, typically bacterial infection, infects a joint through bloodstream.
There are a number of bacteria that can lead to septic arthritis. But in most cases, the disease is caused by staphylococcus aureus (staph), a kind of bacteria that commonly lives on even normal-healthy skin.
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The story usually starts from elsewhere in the body. For example, an infection in the skin or urinary tract can travel through the circulation to the joint tissue. Less commonly – open wounds, surgery, and injections can also give the germs /bacteria entry into the joint space.
When your joint structure gets infected, inflammation – as a result of the body’s reaction to the infection – occurs. While this inflammation is the normal way of the body to respond the infection, this can also contribute to the damage and cause other discomforts. The inflammation can reduce blood flow and increase pressure within the joint, making your joint become more painful.
How about the symptoms? The symptoms vary, depending on several factors especially such as medication you’re taking and your age.
Typically, joint pain worsens with movement and you tend to avoid putting any weight on your affected joint. Sometimes other non-joint structure symptoms occur, these include; fever or chills, appetite loss, fatigue (weakness), and irritability.
Young children with the disease will usually cry when the affected joint is moved, during nappy changing for example. They also become more irritable.
The disease can occur in any joint. But it’s often found in the joints of hips and knees. It usually affects one joint, though sometimes it can also attack more than one joint at the same time.
Physical examination, including closely observing any symptoms that occur, can help identify the underlying cause. But since the symptoms of septic arthritis can be like many other joint diseases, several tests are required.
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A procedure called arthrocentesis is usually used to help diagnose this infectious arthritis. It is a test that involves a surgical puncture by inserting tiny needle into the joint to draw a sample of joint’s lubricant fluid (synovial fluid). Then with laboratory test, the sample is closely examined to look for any organism that causes the infection.
Other tests such as blood test and imaging test (X-rays or CT-scan) may also be required to help provide an accurate diagnosis so your doctor can fully understand which medications to prescribe!
Again, most patients can have a full recovery without serious complication after treatment. But without prompt treatment, the disease could turn into serious or even become life-threatening. Some potential complications are as follows:
- Dysfunctional joint. If left untreated, the disease may cause joint degeneration and serious /permanent damage.
- Osteomyelitis, an infectious bone disease. It’s possible for the infection to spread to other joint structures such as bones.
- Sepsis, a rare medical condition as a result of the body’s reaction to infection. It occurs if the body releases certain chemicals into the circulation (when your body gets infected) that trigger overwhelming inflammatory responses throughout the body. It is an emergency condition, early treatment is important before it becomes advanced!
Since most cases of septic arthritis are caused by bacterial infection, the main treatment is antibiotics. At first, antibiotics are usually given ‘intravenously’, given directly through a vein. Later, oral antibiotics can be given for several weeks.
It usually takes about 1-2 weeks to stay in hospital. Bed rest for a few days is important to take any extra pressure off your affected joint. Meanwhile, pain medication is often prescribed to help relieve the pain.
If necessary, a procedure called arthroscopy may be suggested. This is to help drainage the infected fluid joint by inserting a needle and syringe into the affected joint. Sometimes you may require an open surgery for some joints that are more difficult to drain (the hip for example).
With early and prompt treatment, the infection should not turn into serious and you can have a full recovery. After treatment, you may wonder whether or not the disease will return.
The chance of septic arthritis to come back varies from person to person. In general, this is dependent on the following factors: