Septic Arthritis

Septic arthritis is the most rapid and destructive joint disease, and is associated with significant morbidity and a mortality of 10%.

This has not improved over the last 20 years, despite advances in antimicrobial therapy.

The incidence is 2–10 per 100,000 in the general population, and 30–70 per 100,000 in those with pre­existing joint disease or joint replacement.

Septic arthritis is usually due to haematogenous spread from either skin or upper respiratory tract; infection from direct puncture wounds or secondary to joint aspiration is uncommon.

Risk factors include;

• Increasing age,
• Pre existing joint disease (principally RA),
• Diabetes mellitus,
• Immunosuppression (by drugs or disease),
• Intravenous drug misuse.

In RA, the skin is a frequent portal of entry because of maceration of skin between the toes due to joint deformity and difficulties with foot hygiene due to hand deformity. 

Infants and older adults are most likely to develop septic arthritis.

Knees are most commonly affected, but septic arthritis also can affect hips, shoulders and other joints.

The infection can quickly and severely damage the cartilage and bone within the joint, so prompt treatment is crucial. 

• Severe pain that worsens with movement
• Swelling of the joint
• Warmth and redness around the joint

• Fever

• Chills
• Fatigue
• Weakness
• Decreased appetite
• Rapid heart rate
• Irritability 

Any joint can be affected, lower limb joints, such as the knee and hip, are commonly targeted.

Infectious arthritis is a type of arthritis that occurs when bacteria or viruses, or other organisms get into the fluid between joints and multiply.

In adults, the most likely organism is Staphylococcus aureus, particularly in patients with RA and diabetes.

In young, sexually active adults, disseminated gonococcal infection occurs in up to 3% of untreated gonorrhoea, usually presenting with migratory arthralgia, low grade fever and tenosynovitis, which may precede the development of oligo­ or monoarthritis.

other factors

Painful pustular skin lesions may also be present.

Amongst the older people and intravenous drug users, Gram Negative bacilli or group B, C and G streptococci are important causes.

Group A streptococci, pneumococci, meningococci and Haemophilus influenzae are occasionally isolated. 

Joint and bone infection in old age:

Vertebral infection i.e.:

• More common.
• Recognition may be delayed, as symptoms may be attributed to compression fractures caused by osteoporosis

Peripheral vascular disease i.e.:

• Leads to more frequent involvement of the bones of the feet, and diabetic foot ulcers are also commonly complicated by osteomyelitis.

Prosthetic joint infections i.e.:

• Now more common because of the increased frequency of prosthetic joint insertion in older people.

Gram-negative bacilli i.e.:

• More frequent pathogens than in younger people. 

Prompt diagnosis of septic arthritis is necessary to prevent permanent damage to the joint.

In addition to a complete medical history and physical examination, diagnostic procedures for septic arthritis may include:

Removal of joint fluid:

• This is done to examine for white blood cells also bacteria.

Blood tests:

• In brief, These tests are done to detect bacteria.

Phlegm, spinal fluid, and urine tests:

• These tests are done to detect bacteria also find the source of infection.

X-ray:

• A diagnostic test that uses invisible electromagnetic energy beams to produce images of internal tissues, bones, also organs onto film.

Bone scan:

• A nuclear imaging method to evaluate any degenerative and/or arthritic changes in the joints to detect bone diseases also tumors to determine the cause of bone pain or inflammation.

Magnetic resonance imaging (MRI):

• A diagnostic procedure that uses a combination of large magnets, radio frequencies, additionally a computer to produce detailed images of organs and structures within the body.

Radionuclide scans:

• Generally, Nuclear scans of various organs to determine blood flow to the organs. 

Risk factors for septic arthritis include:

Existing joint problems i.e.:

• Chronic diseases and conditions that affect your joints such as osteoarthritis, gout, rheumatoid arthritis or lupus can increase your risk of septic arthritis, as can an artificial joint, previous joint surgery and joint injury.

Taking medications for rheumatoid arthritis i.e.:

• People with rheumatoid arthritis have a further increase in risk because of medications they take that can suppress the immune system, making infections more likely to occur.
• Diagnosing septic arthritis in people with rheumatoid arthritis is difficult because many of the signs and symptoms are similar.

Skin fragility i.e.:

• Skin that breaks easily and heals poorly can give bacteria access to your body.
• Some skin conditions such as psoriasis and eczema increase your risk of septic arthritis, as do infected skin wounds.
• People who regularly inject drugs also have a higher risk of infection at the site of injection.

Weak immune system i.e.:

• People with a weak immune system are at greater risk of septic arthritis.
• This includes people with diabetes, kidney and liver problems, and those taking drugs that suppress their immune systems.

Joint trauma i.e.:

• Animal bites, puncture wounds or cuts over a joint can put you at risk of septic arthritis.
• Having a combination of risk factors puts you at greater risk than having just one risk factor does. 

Homeopathic treatment for septic arthritis is natural, safe and without any side-effects, and one can enjoy immense relief from these frustrating symptoms.

It is a patient-oriented science and medicines are prescribed on the characteristics of the individual rather than just the symptoms of the disease.

Apis Mellifica:

• Used for swelling of joint with synovitis also synovial effusion, septic arthritis, red hot swollen joint , pain on slightest either pressure or motion, gout , rheumatoid arthritis , post viral arthritis and arthralgia.

Arnica Montana:

• Use in blunt injury also trauma, sore unimpressive bruised sensation with swelling concussion and contusion call for this remedy.

Bryonia Alba:

• Generally, Stiffness and pain with hot swelling, redness of joints with stitching and tearing pain aggravation on least motion every spot is painful on slightest pressure.

Hypericum Perfoliatum:

• This is the remedy for degenerative changes of joints involving nerves, sciatica, coccygodynia, cervical and lumbar spondylosis with nerve compression, additionally tingling burning and numb sensation with lancinating pain calls for the remedy, darting pain of shoulders , cramps in calf muscles, pain in tips of toes also fingers, sensation of pressure along the ulnar side if arm.

Other remedies:

• Rhus Toxicodendron
• Ledum Palustre
• Bellis Perennis
• Belladonna 
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What is Septic Arthritis ?

Septic arthritis is an infection in the joint (especially synovial) fluid and joint tissues. It is also known as “Infectious Arthritis.”

Homeopathic Medicines used by Homeopathic Doctors in treatment of Septic Arthritis ?

• Apis Mellifica
• Arnica Montana
• Bryonia Alba
• Hypericum Perfoliatum
• Rhus Toxicodendron
• Ledum Palustre

What is the most common cause Septic Arthritis ?

The most likely organism is Staphylococcus aureus.

What are the symptoms of Septic Arthritis ?

• Severe pain that worsens with movement
• Swelling of the joint
• Warmth and redness around the joint

• Fever

• Chills
• Fatigue
• Weakness

1. Davidson’s Principles and Practice of Medicine (22nd edition) Ch. 25
2. https://www.mayoclinic.org/diseases-conditions/bone-and-joint-infections/diagnosis-treatment/drc-20350760
3. https://www.healthline.com/health/septic-arthritis#treatments
4. https://www.stanfordchildrens.org/en/topic/default?id=septic-infectious-arthritis-90-P01730
5. https://atomictherapy.org/arthritis/