PYOGENIC ARTHRITIS

1. PYOGENIC ARTHRITIS

2. INTRODUCTION
• Pyogenic arthritis are defined as the infections occurring in the joints
that is Caused by staphylococcus and less commonly by streptococci,
pneumococci, gonococci meningococci .
It is also known as septic arthritis , infective arthritis, suppurative
arthritis.

3. Incidence and Prevalence
• The ratio of the septic arthritis in adults as compared to children is
1:1.5.
• The prevalence of non-gonococcal septic arthritis in emergency
department patients with a single acutely painful joint is
approximately 27%.

4. Routes of the infection
• Direct implantation of the bacteria
• Iatrogenic
• Hematogenesis spread
• Secondary to osteomyelitis

5. PATHOGENESIS
• Inflammation of the synovial membrane with excess production of
joint fluid and pus.
• The fluid contains a large number of cells, bacteria and fibrin .
• There occurs a destruction of the articular cartilage and underlying
bone.
• Pus can escape and form sinuses.

6. Clinical features
• High grade fever
• Swelling
• Pain
• Tenderness
• warmth

7. INVESTIGATIONS
• Radiographs may be normal or may show increased joint space due to
fluid or pus collection.
• Later radiographs show destruction of the cartilage, new bone
formation, eventually bony ankylosis
• Ultrasonography is required especially in children to detect collection
of fluid.
• Blood test : marked elevation of ESR and leucocyte count
• neutrophil leucocytosis
• Aspiration of the joint fluid may show organisms on smear and
culture.

8. Treatment
• Rest
• Antibiotic drugs
• Arthrotomy
• Joint aspiration

9. Physiotherapy Management
• During the active stage,
• Patient education
• Reduce pain .
• Check immobilization for comfortable resting position of the affected
joint
• No range of motion or strengthening exercises to be given

10. During Inactive or Quiescent stage
• Relaxed rhythmic active movements should be started to the affected
joint by providing the required assistance.
• Isometrics should be started.
• Rehabilitation is aimed at restoring normal range of motion, flexibility
, strength and endurance
• The goal of the rehabilitation is to maintain function and enhance
mobility.
• Active range of motion initially will help to maintain flexibility and
strength and relives the musculoskeletal pain associated with
muscular weakness, paralysis and immobility.

11. REFERENCES
• G S Kulkarni Textbook of Orthopaedics.
• Rutherford AI, Subesinghe S, Bharucha T, Ibrahim F,A population study
of the reported incidence of narrative joint septic arthritis in the
united kingdom .
• Jayant Joshi textbook of Orthopaedic and applied physiotherapy.

12. THANK YOU