The document compares septic arthritis and gouty arthritis. Septic arthritis is caused by bacterial, viral, or fungal infection in the joint, commonly affecting those with underlying medical issues. It is diagnosed by synovial fluid showing infection and treated with antibiotics and surgical drainage. Gouty arthritis is caused by elevated uric acid levels leading to urate crystal formation in the joints. It is diagnosed by crystals seen in synovial fluid and treated by reducing uric acid levels. Both can lead to joint damage if untreated, while septic arthritis risks spread to bones and gouty arthritis risks severe long-term joint destruction.

1. The
Objective
15 – 20 min 25 Slides May 09, 2017
Comparison between
Septic & Gouty
arthritis.

2. The
15 – 20 min 25 Slides May 09, 2017
Objective
Compare between septic arthritis and gouty arthritis.

3. Categories
Arthritis

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5. Septic
Inflammation of a synovial membrane with
purulent effusion into the joint capsule,
due to infection.
Definition

6. Septic
Bacterial, but sometimes viral or fungal.
Usually by Staphylococcus aureus.
Other organisms are :
E.coli , Proteus , Streptococcus
Causes

7. Septic
Rheumatoid arthritis,
Immunosuppressive drug therapy,
Chronic disorder,
AIDS & Intravenous drug abuse
Risk Factors

8. Septic
Haematogenous InoculationAdjacent infection
Commonest
Usually affect people
with underlying
medical problem
Common in children.
Osteomyelitis from the
bone to the joint.
Penetrate in trauma
Pathogenesis

9. Septic
1st, Acute synovitis with a purulent joint effusion.
2nd,Articular cartilage is attacked.
3rd, Cartilage may be completely destroyed.
4th, Healing then leads to ankylosis.
Pathogenesis

10. Septic
- Bone destruction & dislocation of the joint.
- Cartilage destruction:
fibrosis bony, ankylosis or 2ry osteoarthritis.
- Growth disturbance:
localized deformity or shortening of the bone.
Complication

11. Septic
- Synovial fluid ( Purulent, Low viscosity, high WC & Infection )
- Blood tests ( ESR > 40, CRP > 20, high WC & May be infection )
- Differential diagnosis ( No crystals )
- X-ray or Ultrasonography
Diagnosis

12. Septic
- Analgesics & IV fluids.
- The joint is rested.
- Antibiotic starts immediately.
- Surgical Drainage.
Treatment

13. Septic
If left untreated:
it will spread to the underlying bone and out
of the joint to form abscess and sinus.
Prognosis

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15. Gouty
Inflammatory arthritis associated with
hyperuricemia.
Definition

16. Gouty
High uric acid in the blood.
Causes

17. Gouty
Decreased excretion 90%
Increased production 10%
In born error of metabolism 1%
Causes

18. 1.Increasing age 2.Obesity
3.High protein diet 4.High alcohol consumption
5.Diabetes mellitus 6.Ischemic heart disease
7.Hypertension
Risk Factors
Gouty

19. Gouty
Uric acid accumulate in blood and tissues.
Leak forming crystals & enters the joints.
Crystals are less soluble
under acid ph. & low temperatures.
Pathogenesis

20. Gouty
Pathogenesis
→ → → →
WBC
Chemotaxis
Phagocytosis
Lysis:
Release of crystals
& lysosomes

21. - Severe degenerative arthritis.
- Secondary infections.
- Urate or uric acid nephropathy.
- Renal stones.
Complication
Gouty

22. Gouty
- Synovial fluid ( Cloudy, Normal viscosity, high WC & Crystals )
- Blood tests ( Uric acid > normal 3.4-7.0 mg/dl “male” )
- Differential diagnosis ( culture )
Diagnosis

23. Gouty
- Rest of the joint.
- Anti-inflammatory drugs.
- Uricosuric agents.
- Uric acid synthesis inhibitors.
Treatment

24. Gouty
If left untreated:
- Acute gout usually resolves in a week.
- Chronic gout can lead to severe joint
Destruction & joint deformity.
Prognosis

25. Summary

26. Summary

27. Summary
Septic Gouty
Common Site
Diagnosis
Risk Factors
Cause
Definition
Complications
Treatment
Inflammatory arthritis
Associated with hyperuricemia.
Inflammatory arthritis
Associated with Infection.
High uric acid in the blood.
Bacterial,
but may be viral or fungal.
High protein diet, Diabetes, Obesity,
Aging, alcohol abuse, Hypertension
& Ischemic heart disease.
Rheumatoid arthritis,
Immunosuppressive drug therapy,
Chronic disorder, & AIDS
Big toe.Knee.
Severe degenerative arthritis.
Secondary infections.
Urate or uric acid nephropathy.
Renal stones.
Bone destruction
dislocation of the joint.
Cartilage destruction.
Growth disturbance.
Differential diagnosis:
Positive for crystals.
Negative for Infection.
Differential diagnosis:
Negative for crystals.
Positive for Infection.
Rest of the joint.
Anti-inflammatory drugs.
Uricosuric agents.
Uric acid synthesis inhibitors.
Analgesics & IV fluids.
The joint is rested.
Antibiotic starts immediately.
Surgical Drainage.

28. Advisor >
Dr. Fath
Websites >Robbins 9th > QuMed >
• Diseases of Joints Lecture 38.
• Arthritis. SlideShare
Wiki
Sources & References