Septic arthritis physical examination: Difference between revisions
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{{CMG}}; {{AE}}{{VSKP}} | {{CMG}}; {{AE}}{{VSKP}} | ||
==Overview== | ==Overview== | ||
Patients with septic arthritis usually appear toxic.Common physical examination findings of septic arthritis include erythema, warmth, swelling and | Patients with [[septic arthritis]] usually appear [[toxic]].Common physical examination findings of septic arthritis include [[erythema]], warmth, [[swelling]], [[tenderness]] and decreased [[range of motion]] over the affected [[joint]], usually [[knee]]. | ||
==Physical Examination== | ==Physical Examination== | ||
=== Appearance of the Patient === | === Appearance of the Patient === | ||
* Patient with septic arthritis usually appears toxic and with joint pain | * Patient with [[septic arthritis]] usually appears [[toxic]] and with [[joint pain]] | ||
* children usually appear irritable | * children usually appear [[irritable]] | ||
=== Vital Signs === | === Vital Signs === | ||
* Low grade fever. Chills and spiking fever are very rare. | * Low grade [[fever]]. [[Chills]] and spiking fever are very rare. | ||
* Hyperthermia over the joint involved | * [[Hyperthermia]] over the joint involved | ||
* Tachycardia | * [[Tachycardia]] | ||
* Tachypnea | * [[Tachypnea]] | ||
=== Skin === | === Skin === | ||
* | * Warmth over the joint | ||
* Erythema over the around the joint that involved | * [[Erythema]] over the around the joint that involved | ||
* Disseminated gonococcal infection often present with skin lesions, typically multiple, painless macules and papules, most often found on the arms or legs or on the trunk.<ref name="pmid9449882">Goldenberg DL (1998) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=9449882 Septic arthritis.] ''Lancet'' 351 (9097):197-202. [http://dx.doi.org/10.1016/S0140-6736(97)09522-6 DOI:10.1016/S0140-6736(97)09522-6] PMID: [https://pubmed.gov/9449882 9449882]</ref> | * [[Disseminated gonococcal infection]] often present with [[skin]] lesions, typically multiple, painless [[macules]] and [[papules]], most often found on the arms or legs or on the [[trunk]].<ref name="pmid9449882">Goldenberg DL (1998) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=9449882 Septic arthritis.] ''Lancet'' 351 (9097):197-202. [http://dx.doi.org/10.1016/S0140-6736(97)09522-6 DOI:10.1016/S0140-6736(97)09522-6] PMID: [https://pubmed.gov/9449882 9449882]</ref> | ||
=== Extremities === | === Extremities === | ||
Most commonly involves knee > hip > shoulder > ankle.<ref name="pmid3498362">Barton LL, Dunkle LM, Habib FH (1987) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=3498362 Septic arthritis in childhood. A 13-year review.] ''Am J Dis Child'' 141 (8):898-900. PMID: [https://pubmed.gov/3498362 3498362]</ref> Other joints such as sacroiliac joint (~10%), | Most commonly involves [[knee]] > [[hip]] > [[shoulder]] > [[ankle]].<ref name="pmid3498362">Barton LL, Dunkle LM, Habib FH (1987) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=3498362 Septic arthritis in childhood. A 13-year review.] ''Am J Dis Child'' 141 (8):898-900. PMID: [https://pubmed.gov/3498362 3498362]</ref> Other joints such as [[sacroiliac joint]] (~10%), [[sternoclavicular]] or costoclavicular joints may be involved in patient with history of intravenous drug abuse (IVDA), penetrating trauma, animal or human bites and local [[steroid]] [[injections]]. | ||
* Swelling of the joint that involved | * [[Swelling]] of the joint that involved | ||
* Decreased range of motion such as pseudo paralysis | * Decreased [[range of motion]] such as pseudo paralysis | ||
* Patient hold the hip in flexed and externally rotated position if SA involving hip. | * Patient hold the hip in flexed and externally rotated position if SA involving [[hip]]. | ||
* If child, unwillingness to bear weight on the affected joint (antalgic gait) | * If child, unwillingness to bear weight on the affected joint (antalgic gait) | ||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
{{WH}} | |||
{{WS}} | |||
[[Category:Arthritis]] | [[Category:Arthritis]] | ||
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[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Rheumatology]] | [[Category:Rheumatology]] | ||
[[Category:Emergency medicine]] | |||
[[Category:Emergency mdicine]] | |||
[[Category:Up-To-Date]] | |||
[[Category:Infectious disease]] | [[Category:Infectious disease]] | ||
[[Category: | [[Category:Orthopedics]] | ||
Latest revision as of 00:09, 30 July 2020
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Septic arthritis Microchapters |
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Septic arthritis physical examination On the Web |
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American Roentgen Ray Society Images of Septic arthritis physical examination |
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Risk calculators and risk factors for Septic arthritis physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Venkata Sivakrishna Kumar Pulivarthi M.B.B.S [2]
Overview
Patients with septic arthritis usually appear toxic.Common physical examination findings of septic arthritis include erythema, warmth, swelling, tenderness and decreased range of motion over the affected joint, usually knee.
Physical Examination
Appearance of the Patient
- Patient with septic arthritis usually appears toxic and with joint pain
- children usually appear irritable
Vital Signs
- Low grade fever. Chills and spiking fever are very rare.
- Hyperthermia over the joint involved
- Tachycardia
- Tachypnea
Skin
- Warmth over the joint
- Erythema over the around the joint that involved
- Disseminated gonococcal infection often present with skin lesions, typically multiple, painless macules and papules, most often found on the arms or legs or on the trunk.[1]
Extremities
Most commonly involves knee > hip > shoulder > ankle.[2] Other joints such as sacroiliac joint (~10%), sternoclavicular or costoclavicular joints may be involved in patient with history of intravenous drug abuse (IVDA), penetrating trauma, animal or human bites and local steroid injections.
- Swelling of the joint that involved
- Decreased range of motion such as pseudo paralysis
- Patient hold the hip in flexed and externally rotated position if SA involving hip.
- If child, unwillingness to bear weight on the affected joint (antalgic gait)
References
- ↑ Goldenberg DL (1998) Septic arthritis. Lancet 351 (9097):197-202. DOI:10.1016/S0140-6736(97)09522-6 PMID: 9449882
- ↑ Barton LL, Dunkle LM, Habib FH (1987) Septic arthritis in childhood. A 13-year review. Am J Dis Child 141 (8):898-900. PMID: 3498362