Search
infectious arthritis in the elderly
Etiology:
1) most common causative organisms
a) Staphylococcus aureus
b) Streptococcus
c) gram negative bacilli increasing in frequency
2) risk factors
a) cancer
b) immunosuppression
c) chronic illness
1] diabetes mellitus (24% of patients)
2] chronic renal failure
d) prosthetic joint surgeries
e) chronic arthritis
f) recent procedures
Pathology:
- knee is most common joint
Clinical manifestations:
1) frequently afebrile
2) joint out of sync
3) (see infectious arthritis)
Laboratory:
1) complete blood count - WBC is often normal on presentation
2) erythrocyte sedimentation rate (ESR)
a) usually elevated
b) average value 79 mm/hr
Radiology:
- 71% have radiologic evidence of pre-existing joint disease
Complications:
1) 38% develop osteomyelitis
2) 19% mortality due to sepsis
Differential diagnosis:
1) sexually transmitted disease
2) cellulitis
4) regional sympathetic dystrophy (RSD)
5) bursitis
6) osteomyelitis
7) crystalline arthropathy (gout, pseudogout)
Management: see infectious arthritis
General
infections in the elderly
infectious arthritis (septic arthritis)
References
- Weiner S, In: UCLA Intensive Course in Geriatric Medicine
& Board Review, Marina Del Ray, CA, Sept 12-15, 2001