Paediatrics: Septic Arthritis and Osteomyelitis: Free MSRA Podcast

⚕️ FREE MSRA PODCAST – Septic Arthritis (Paediatrics)🎧 A clear, high-yield breakdown of this acute, limb-threatening joint infection in children – perfect for exam prep and real-life clinical scenarios.🧠 Key Learning Points📌 Definition• Septic arthritis is an acute infection of a native joint, causing rapid inflammation and destruction. It’s a paediatric emergency that needs urgent treatment to preserve joint function.📌 Causes & Risk Factors• Bacterial infection is the main cause – especially:Staphylococcus aureus (most common overall)Streptococcus pneumoniaeHaemophilus influenzae (now less common post-vaccine)Kingella kingae (especially <4 years old)• Most often spreads via the bloodstream (haematogenous spread)• Risk factors:Very young age (especially <3 months)Immunocompromised childrenRecent infection (skin/respiratory)Trauma or surgery near a jointSickle cell disease, chronic illnessesMnemonic: “SHiNK” – Staph, Hib, Neumo, Kingella📌 Pathophysiology• Bacteria invade the joint → intense inflammatory response• Purulent (pus) accumulation causes pressure and cartilage/bone destruction• If untreated, infection can spread (sepsis, osteomyelitis)📌 Symptoms• Acute joint pain (often hip, knee, or ankle – “HKA”)• Fever, irritability, refusal to bear weight or move the limb• Swollen, red, warm, tender joint• Child may appear generally unwell, lethargic, decreased appetiteMnemonic: “FIL” – Fever, Irritability, Limp📌 Differential Diagnosis• Juvenile idiopathic arthritis (JIA)• Reactive arthritis• Viral arthritis• Lyme disease• Osteomyelitis• Malignancy• Trauma• Other infections (e.g. endocarditis-related)📌 Diagnosis• Joint aspiration (arthrocentesis): gold standardPurulent fluid, high WCC, Gram stain/culture• Blood cultures (at least two sets)• Inflammatory markers: raised CRP, ESR, white cell count• Imaging:Ultrasound (detect effusion, guide aspiration)X-ray (rule out other causes, later bony changes)MRI (for complications/osteomyelitis)• COCHER criteria for septic hip:Fever >38.5°CNon-weight bearingNeutrophilia/WCC >12,000WSR (ESR) >40 mm/hr📌 Management• Immediate IV antibiotics (empiric, then targeted by culture)• Urgent drainage of the joint – repeated aspiration or surgical washout• Splinting limb in a functional position• Supportive care: pain management, fluid balance• Prolonged course of antibiotics (IV then oral, 4–6 weeks)• MDT approach: paediatrics, orthopaedics, microbiology📌 Complications• Joint destruction and deformity• Chronic pain, loss of function, limb length discrepancy• Growth disturbance (children)• Osteomyelitis• Abscess formation• Sepsis and systemic complications• Rarely: amputation, joint fusion surgery📌 Prognosis• Prognosis depends on organism and speed of treatment – delayed diagnosis increases risk of permanent disability. About 1/3 develop complications. Early recognition and intervention are key.📎 More MSRA Resources for Septic Arthritis📝 Revision Notes: https://www.passthemsra.com/topic/septic-arthritis-revision-notes/🧠 Flashcards: https://www.passthemsra.com/topic/septic-arthritis-flashcards/💬 Accordion Q&A Notes: https://www.passthemsra.com/topic/septic-arthritis-accordion-qa-notes/🚀 Rapid Quiz: https://www.passthemsra.com/topic/septic-arthritis-rapid-quiz/🎓 Full Course: https://www.passthemsra.com/courses/paediatrics-for-the-msra/#MSRA #MSRARevision #MSRATextbook #MSRAQuiz #MSRAQuestionBank #MSRAFlashcards #MSRAQ&ANotes #MSRAAccordions #MultiSpecialityRecruitmentAssessment #MSRAOnlineRevision #MSRARevisionWebsite #Paediatrics #SepticArthritis