Hou Zengtao, director of the Bone Joint and Trauma Surgery Center of Haici Medical Group, said that infectious arthritis is an infection of joint parts after bacteria or viruses invade the joint cavity of human body. Infectious arthritis often attacks children or the elderly with weak resistance. The most common pathogens are Staphylococcus aureus and Neisseria gonorrhoeae, but various mycobacteria, spirochetes, fungi and viruses can also infect joint cavities. Sepsis is the main cause of infection. In addition, trauma, surgery and soft tissue infection near joints are also important reasons.
Manifestations of infectious arthritis
Infectious arthritis mainly involves a single joint, and multi-joint involvement is rare. The main manifestations of patients are redness, swelling, fever, pain and dysfunction.
1, fever: body temperature is 38.3~38.9, sometimes higher. But it may not be fever, especially for people with rheumatoid arthritis, liver and renal insufficiency or who need immunosuppressive treatment.
2, joint swelling and pain: In addition to deep joints such as hip joint, shoulder joint and ankle joint, joint swelling and pain usually occur.
3, joint cavity effusion: joint cavity can accumulate a large number of serous, cellulosic or purulent exudates.
4. Limb activity is limited: due to the stimulation of inflammation and pain, the affected limb muscles have protective spasms, and the limbs are mostly in flexion position. At the same time, due to the development of inflammation, the pus in the joint increases, so that the affected limb is fixed in the position where the joint space is fully expanded, and the joint cannot move actively.
Director Hou Zengtao's team surgery
Common disease site
About 90% of patients present with single joint involvement. Knee joint is the most common, followed by hip joint, shoulder, wrist and elbow joint are the least. Arthritis of small joints of hands and feet often occurs after direct inoculation or bite.
How to treat infectious arthritis
The treatment of infectious arthritis is divided into general treatment, drug treatment and surgical treatment.
general treatment
Patients should stay in bed and brake. Increase nutrition, correct the disorder of water and electrolyte metabolism, transfuse a small amount of blood or albumin many times, and improve the whole body resistance. Control the primary infection focus, relieve pain, etc.
medicine
1, systemic medication
Use sufficient and effective antibiotics. If conditions permit, do bacterial culture and drug sensitivity test of joint effusion as much as possible, and choose the most sensitive antibiotics according to the results.
2, local medication
Puncture the joint cavity every other day or every 3~4 days according to the situation, drain the effusion in the joint cavity as much as possible, and then inject effective antibiotics.
Surgical therapy
1, puncture and drainage
Puncture and drain every day, and then rinse with normal saline or Ringer's solution. Be careful not to inject antibiotics directly into the joint cavity to avoid local inflammation.
2. Surgical drainage
Generally, the treatment lasts for 4~7 days, and surgical drainage is only performed when there is still no improvement. Thoroughly remove abscess and necrotic synovium, but don't destroy the blood supply of metaphyseal end, and pay attention to keep the drainage unobstructed.
Can infectious arthritis be treated with traditional Chinese medicine?
Infectious arthritis is different from arthritis such as rheumatoid arthritis and gouty arthritis. It is a pathological change caused by bacteria or fungi. It is not recommended for people to adopt Chinese medicine treatment methods such as scald, acupuncture, obedience, moxibustion and acupoint injection. They should go to regular hospitals for regular antibacterial treatment and surgical treatment to avoid joint function loss due to delayed illness.
How to prevent infectious arthritis
Infectious arthritis is a preventable disease. Avoiding joint trauma and actively treating infectious diseases can effectively reduce the risk of infectious arthritis.
1, avoid joint trauma, pay attention to the safety of sports venues and sports equipment, and avoid injury. Warm up before exercise, and the amount of exercise will gradually increase from small to large. Don't start with a lot of exercise. Relax after a lot of exercise. Old people should avoid falling when walking.
2. Actively treat diseases such as sepsis and soft tissue infection.
3, strengthen physical exercise, enhance physical fitness, improve resistance.
Expert recommendation
Hou zengtao
Director, Deputy Chief Physician, Doctor of Medicine, and Master's Tutor of Bone and Joint and Trauma Surgery Center. He is also a member of Orthopaedics Branch of Chinese Medicine Association, Orthopaedics Branch of Shandong Association of Integrated Traditional Chinese and Western Medicine, Orthopaedics Branch of Shandong Geriatrics Association, Shandong Planning and Training Base, and Orthopaedics Branch of Qingdao Medical Association. He studied in Shanghai Sixth Hospital and Beijing Third Hospital, and worked as a visiting scholar in Germany AMEOS Hospital and Korea Yanshi Youai Hospital. In recent five years, he has published 3 SCI papers, more than national academic papers 10, 3 national invention patents, 1 utility model patent 1, presided over provincial projects 1 and 2 municipal projects. 20 15 and 20 17 were awarded the title of "Qingdao Excellent Young Medical Talents".
He is good at dealing with all kinds of complex fractures, replacement and revision of artificial hip and knee joint, and arthroscopic minimally invasive treatment of sports injury diseases (meniscus injury, rupture of anterior and posterior cruciate ligament, recurrent dislocation of patella, cartilage injury of knee joint, scapulohumeral periarthritis, rotator cuff tear, recurrent dislocation of shoulder joint, glenoid lip injury, ankle instability, hip collision, etc. ).