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Good Morning and Welcome Applicants!

Good Morning and Welcome Applicants!. December 2, 2010. Septic Arthritis Osteomyelitis. Septic Arthritis. Most common organism? Staph Aureus Presentation? Acute Monoarthritis Erythema Warmth Swelling Intense pain on movement Fever – 70%. Septic Arthritis.

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Good Morning and Welcome Applicants!

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  1. Good Morning and Welcome Applicants! December 2, 2010

  2. Septic Arthritis Osteomyelitis

  3. Septic Arthritis • Most common organism? • Staph Aureus • Presentation? • Acute • Monoarthritis • Erythema • Warmth • Swelling • Intense pain on movement • Fever – 70%

  4. Septic Arthritis • Definitive Diagnostic Test? • Joint fluid anaylsis and culture • Other labs or studies? • CBC • ESR/CRP • US • CT/MRI

  5. Septic Arthritis • Emergency? • Outcome depends of timing of diagnosis, initiation of antibiotics, adequacy of drainage, virulence and host factors

  6. Osteomyelitis • Presentation • Fever • Localized pain • Erythema • Swelling • Pinpoint tenderness • Decreased ROM

  7. Osteomyelitis • Diagnosis? • Bone scan • MRI • Bone Culture • Other labs? • WBC • ESR/CRP • Blood culture – 60% • Bone culture – 80% • Plain films

  8. Transient or Toxic Synovitis • Emergency? • Benign, self-limited • Causes? • Acute or post infection • Trauma • 30% of all nontraumatic limps

  9. Transient Synovitis • Presentation? • Limp • Painful hip • Afebrile or low-grade • Otherwise appears well • Mild restriction of ROM

  10. Transient Synovitis • Diagnosis? • Exclude septic arthritis and osteo • Four predictors associated with septic arthritis • History of fever • Inability to bear weight • ESR >40 • WBC >12

  11. Transient Synovitis • Treatment? • Rest • Anti-inflammatory • Most children do very well

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