Infectious Arthritis: symptoms, treatment

Every 3rd patient who comes to a rheumatologist with a complaint of joint inflammation, according to statistics, suffers from infectious arthritis. This disease requires immediate consultation with a doctor, because it can completely and irreversibly destroy a joint in a couple of days, and every 12th of those who are unlucky enough to get the disease die every year from its complications. But if you go to the hospital in a timely manner, 70% of patients get off with a “mild fright” - modern medicine allows you to save joints from deformation in most cases.

Let's look at the symptoms and treatment of infectious arthritis.

Infectious arthritis - what is it?

Infectious arthritis is characterized by an inflammatory process occurring inside the joint. This may be caused by bacteria, viruses, parasites or fungi.

This type of arthritis can affect absolutely any joint.

. A characteristic feature of the disease is that in addition to local manifestations (swelling, pain and joint immobility), there are also general symptoms (fever, chills, signs of intoxication).

Infectious arthritis refers to a group of diseases caused by various types of infectious agents that penetrate specifically into the structure of the tissues that form the joint.

According to existing statistics in the field of rheumatology and traumatology, arthritis of this type is diagnosed in every third patient.

The most common site of infectious arthritis is the joints of the upper and lower extremities

Approaches to the treatment of purulent-inflammatory diseases of large joints

Dear visitors of our site! This article is devoted to the surgical treatment of purulent-inflammatory diseases of the joints, complicated by the destruction of bone tissue (osteomyelitis), and purulent complications of endoprosthetics.

This group of diseases is a serious, unresolved problem in modern orthopedics. There are no uniform standards for the treatment of this pathology. Treatment approaches are based on the personal experience of individual authors and clinics. We would like to highlight the fundamental aspects of diagnosing this group of diseases and share our personal experience of their treatment.

The incidence of septic arthritis ranges from 2 to 10 cases per 100,000 population. The predominant lesion is the knee joint (up to 55%), followed by the hip and ankle joints. Mostly children and the elderly suffer from such diseases.

What are the prerequisites for the development of purulent arthritis? These are injuries to the joint area, degenerative and rheumatoid diseases of the joints, injections in the joint area, arthroscopic interventions, a history of joint replacement, purulent-inflammatory diseases, trophic ulcers of the distal extremities, sexually transmitted infections, systemic administration of glucocorticoids.

Clinical picture of the disease. Manifestations of the disease are quite distinct when joints close to the skin are affected (elbow, knee, ankle). This is tissue swelling in the joint area, local redness and increased skin temperature. When large, deep-lying joints, such as the shoulder and hip, are affected, local changes may not be pronounced, and the patient will only be bothered by pain in the joint area. An increase in body temperature may also not appear immediately. The photograph below shows a typical clinical picture of arthritis of the knee joint: the contours of the right knee joint are smoothed, the joint is increased in volume.

Laboratory diagnosis of the disease. The examination of a patient with a suspected purulent process must necessarily include a clinical blood test with calculation of the leukocyte formula and erythrocyte sedimentation rate, and a blood test for C-reactive protein. Among the laboratory indicators, I would like to dwell specifically on the level of procalcitonin. The procalcitonin test is currently the most objective method for determining the generalization of a bacterial infectious process. A dynamic increase in this indicator in the patient’s blood tests is an indicator of the spread of the purulent process beyond the joint and the development of sepsis.

Instrumental diagnostics: - radiography of the affected joint; — spiral computed tomography of the joint; - joint puncture followed by microscopy and culture of the discharge to determine the infectious agent and its sensitivity to antibiotics. This manipulation must be performed before starting antibiotic therapy.

Treatment. In the treatment of purulent-inflammatory diseases of the joints, our task is to quickly stop the inflammatory process and, if possible, preserve the function of the joint. According to various authors, during a purulent process in the joint, the articular cartilage is affected 4–6 days from the onset of the disease and finally dies off in the 4th week of the disease, after which the effectiveness of joint-preserving operations sharply decreases. In the absence of signs of bone tissue damage, preference is currently given to operations that preserve the joint. If superficial joints are affected in the early stages of the disease, it is possible to use puncture methods and broad-spectrum antibiotic therapy. If puncture methods are ineffective, drainage of the joint is recommended within 48 hours from the onset of the disease. Ideally—most modern authors tend to do this—the use of arthroscopic techniques.

Our personal experience: treatment of septic arthritis of the ankle joint in a 19-year-old patient through 3 weeks of flow-through drainage. The flushing system was installed through accesses up to 2 cm. The result of treatment was complete relief of the inflammatory process and recovery of the patient. During two years of follow-up, no relapse of the disease was noted. When the purulent process spreads to the bone tissue, non-viable tissue is removed and the joint area is stabilized using an external fixation device. As a result, the inflammatory process is stopped and arthrodesis of the affected joint is formed, that is, fusion between the bones that form the joint, which subsequently ensures adequate supporting function of the limb.

Personal experience: An 81-year-old patient was admitted to the clinic with pain in the hip joint that had been bothering her for 4 months after falling from a height. During the week before admission to the clinic, the pain steadily increased, and the supporting function of the limb was impaired. She did not notice any increase in body temperature; she constantly took anti-inflammatory drugs (Movalis) in large doses.

X-ray upon admission.

Zones of destruction are identified in the body of the ilium and in the head of the femur.

Puncture of the hip joint reveals thick purulent contents.

The patient underwent emergency surgery: the joint was opened, the focus of osteomyelitis was sanitized, the head of the femur was removed, the joint was fixed with a rod-based extrafocal device. A flow-through drainage system has been installed. The patient was treated with broad-spectrum antibiotics for 6 weeks. During treatment, pain in the hip joint was relieved, and clinical and laboratory tests showed a decrease in the inflammatory response.

The external fixation device was removed 8 weeks after surgery. The hip joint is fixed with an orthopedic fixator. 3 months after surgery, the fixator was removed. The patient walks independently with full weight bearing on the operated leg. The inflammatory process has been stopped.

Results of spiral computed tomography of the patient’s pelvic bones 3 months after surgery.

Signs of the formation of a fusion between the femur and the body of the ilium are determined. This fusion ensures adequate support function of the limb in the future.

Currently, a serious problem in modern orthopedics is purulent complications of endoprosthetics . According to CITO data for 2012, 80,000 endoprosthetics of large joints were performed in Russia. The ratio of primary and revision endoprosthetics was 9:1. The complication rate for primary arthroplasty of large joints was 2.4%. Of these, 40.6% are infectious complications. The rate of complications during revision arthroplasty was 12.9%. Of these, 51.4% are infectious complications.

In case of early deep suppuration after hip replacement, it is possible to preserve the endoprosthesis . Chronic infection of the endoprosthesis area and destructive osteomyelitis in adults, which developed against the background of septic arthritis, are indications for radical surgical sanitation, removal of endoprosthesis components and necrotic areas of bone tissue.

Approaches to performing operations for suppuration of endoprostheses vary. In our practice, we use articulating spacers (temporary “substitutes” for the prosthesis) - individually made from bone cement with the addition of antibiotics. The use of these devices allows you to maintain limb length, ensure walking with support on the operated leg, improve the patient’s quality of life in the postoperative period, and facilitate subsequent re-endoprosthetics .

Clinical example: Patient 65 years old. History of total hip replacement performed abroad in 2002. No dynamic monitoring of the joint was carried out. Over the past two years, since 2012, I have been experiencing periodic pain in the hip joint. Since September 2013, over the course of 3 months, he has noticed a gradual increase in pain. Two weeks before admission to the clinic, massage of the joint area and acupuncture were performed at home. After a course of these procedures, a sharp increase in pain and a rise in body temperature to 39 degrees were noted.

Radiographs of the patient upon admission.

Signs of destruction of the acetabular component of the prosthesis, signs of destruction of bone tissue along the femoral component of the prosthesis are determined.

During puncture of the joint, thick purulent contents were obtained. The joint cavity was opened, the components of the endoprosthesis were removed, and the osteomyelitis lesion was radically treated. During the inspection, purulent melting of the proximal femur was revealed. An articulating spacer is installed.

X-ray of the patient after surgery.

The model of the proximal femur is formed from bone cement with antibiotics, reinforced with a proximal femoral rod.

The postoperative course is smooth. The inflammatory process has been stopped. Re-endoprosthetics is planned. This clinical example clearly demonstrates the need for timely contact with a specialist traumatologist - orthopedist and the inadmissibility of performing physiotherapeutic procedures without preliminary adequate diagnosis of the cause of pain in the joints.

The Orthocenter specialists are proficient in all methods of surgical treatment of purulent-inflammatory joint diseases and are ready to come to your aid.

Causes of infectious arthritis

The most likely cause of infectious arthritis is the metastatic route of joint damage, which involves direct penetration of infection into the joint tissue through the blood or lymph.

Another route of infection can be injury or an open wound, as well as the spread of pathogens from nearby foci of another disease, for example, osteomyelitis.

Arthritis caused by infectious pathogens in childhood is usually provoked by staphylococcus, enterobacteria or Haemophilus influenzae. However, at the same time, other arthritis, quite specific for this age category, may occur, caused by tuberculosis, gonorrhea or syphilis.

Classification

By origin, purulent arthritis is divided into:

primary
- infection enters the joint due to injury or as a result of medical operations or manipulations;
secondary
- pyogenic microorganisms enter the joint from nearby tissues or distant foci of infection with blood (lymph).

Suppurative arthritis of the knee joint

Based on the nature of changes in tissues, the following forms are distinguished:

without destruction of intra-articular tissues; is possible only with timely and adequate treatment;
with destruction of intra-articular tissues, confirmed by x-ray examination;
with the spread of infection to the periarticular tissues.

Signs and symptoms of infectious arthritis

The key symptom of infectious arthritis is considered to be an acute manifestation, accompanied by a large number of symptoms.

Among the main signs and symptoms of infectious arthritis, general symptoms include fever, chills, excessive sweating and a constant feeling of weakness. As an additional symptom, children may experience nausea and vomiting.

Considering the local signs of infectious arthritis, it is worth highlighting:

sharp pain during palpation/performing movements;
local redness of the skin, swelling, fever.

It is also worth noting that the clinical picture of arthritis of infectious origin directly depends on the causes of its occurrence. Thus, septic arthritis is often localized in large joints, arthritis of gonococcal etiology is accompanied by multiple rashes, and tuberculous arthritis corresponds to a chronic course.

Particular attention should be paid to the symptoms of viral arthritis: short-term course, the possibility of restoration of articular tissues, without negative consequences

Possible localizations

Pyogenic arthritis most often develops in one joint. But people suffering from rheumatoid arthritis may develop purulent polyarthritis.

Chondroprotectors: what are they, how to choose, how effective are they?

Joint pain at rest

Inflammation of the joints of the lower extremities

In large joints of the legs, suppuration is most often the result of open injuries. Sometimes small ones are also affected, especially if the patient already has chronic arthritis.

Purulent arthritis of the hip joint

The hip joint is often involved in the process, but the course is smoothed, without pronounced symptoms of inflammation. This localization is especially dangerous for elderly people with osteoporosis (fragile bones), as it is complicated by long-term non-healing femoral neck fractures. Suppurative arthritis of the hip joint is common in children and is often diagnosed based on x-ray findings, but usually results in complete recovery.

Suppurative arthritis of the knee joint

This is a very common location, since the knee bears the highest load and is often injured. The general condition suffers, redness and swelling of the knee are visible to the eye, and there is severe pain. If it develops against the background of pre-existing chronic arthritis, several joints may be affected at once;

Suppurative arthritis of the ankle joint

The ankle is also often affected after injuries - bruises, bites, etc. Suppuration can spread to the foot, affecting the tendons and ligaments (enthesitis). This complication is associated with severe heel pain. Swelling of the ankle can also lead to the development of tarsal tunnel syndrome, a narrow space behind the inner malleolus where the tibial nerve passes through. Tarsal syndrome is manifested by pain along the foot, flat feet and atrophy of the foot muscles.

Purulent arthritis of the foot

When the small joints of the foot are inflamed, suppuration often joins existing skin (fungal, bacterial) or joint (rheumatoid, gouty arthritis) lesions. It proceeds smoothly, so it is sometimes detected at later stages.

Inflammation of the joints of the upper extremities

Both large and small joints can be affected.

Purulent arthritis of the shoulder joint

The disease often develops after injury or against the background of an existing inflammatory process. It lasts a long time, especially when the glenohumeral joint is affected. The main symptom is severe aching pain. If not treated in time, the pain will bother you for the rest of your life.

Purulent arthritis of the shoulder complicated by osteomyelitis

Suppurative arthritis of the elbow joint

Inflammation of the elbow joint often develops against the background of chronic injury (tennis players) or with psoriatic arthritis.

Purulent arthritis of the hand

The small joints of the hand become suppurated mainly due to rheumatoid arthritis. Against the background of anti-inflammatory treatment, it goes unnoticed, so it is important to pay attention to the slightest changes in your health and consult a doctor in a timely manner.

Purulent arthritis of fingers

This type of arthritis develops against the background of household injuries (cuts, wounds), as well as with psoriatic and gouty arthritis.

Cervical purulent arthritis

Pyogenic arthritis of the cervical spine is rare. This is a very dangerous disease, since pus can enter the brain, swollen periarticular tissues can compress the blood vessels and nerve roots that supply the brain. Therefore, such patients require emergency hospitalization.

Stages of development of infectious arthritis

In order to understand how to treat infectious arthritis and what measures will be most effective, it is important to understand at what stage the disease is.

In total, it is customary to distinguish 4 main stages of arthritis:

Stage 1
– accompanied by the development of osteoporosis (chronically progressive decrease in bone density of the joint), without destructive changes;
Stage 2
– the initial stage of destruction of cartilage tissue, reduction of the joint space, the occurrence of single usurs (destructions on the surface) of the bone;
Stage 3
– significant damage to articular tissues, pronounced reduction in the joint space, the presence of subluxations and deviations (deviations from the norm) of the bones;
Stage 4
– symptoms of stage 3 + complete immobility of the joint.

Types of arthritis of infectious origin

Considering the etiology of the disease, it can be noted that all infectious arthritis have several varieties, including:

bacterial;
viral;
fungal;
parasitic
.

At the same time, depending on the identified type of disease, the following subtypes of arthritis are also distinguished:

septic
(pyogenic/purulent);
gonorrheal
;
syphilic
, etc.

General description of the disease

Bacterial or purulent arthritis is an inflammation of the joint caused by pyogenic bacteria. The disease begins acutely and progresses quickly, threatening the patient's life, and therefore requires emergency care.

Purulent (pyogenic) arthritis is a widespread phenomenon, the incidence ranges from 2 to 10 cases per 100 thousand population. According to statistics, from a quarter to a half of patients after such a purulent inflammatory process become disabled. About 5% of patients cannot be saved.

ICD 10 code(s) for pyogenic arthritis M00-M99. When an infectious pathogen of a certain type is identified, the ICD code is specified:

staphylococcal - M00.0;
pneumococcal - M00.1;
caused by other specified bacterial pathogens - M00.8;
unspecified purulent arthritis has an ICD 10 code - M00.9.

Diagnosis of infectious arthritis

Before determining how to treat infectious arthritis, it is important to understand what its etiology is.

(causes of occurrence) and
forecasts
. All the information necessary for this can be determined diagnostically.

Diagnosis of infectious arthritis is carried out by specialists in the field of surgery, traumatology and rheumatology. If necessary, you can also consult an infectious disease specialist or venereologist for advice.

Among the measures used to clarify the diagnosis, it is worth highlighting:

ultrasound examination of the affected area (ultrasound);
X-ray examination;
CT/MRI of the joint.

The disease is diagnosed in people of different ages: from infants to the elderly.

Tests and diagnostic difficulties

Various diagnostic methods are used to make a diagnosis:

Anamnesis collection.
Visual inspection.
Laboratory tests (general blood and urine analysis).
Puncture with removal of synovial fluid.
X-ray.
Ultrasound
MRI.

When collecting anamnesis, the doctor will find out what previous diseases were suffered, whether the patient has allergies and whether he has had surgical operations. An external examination reveals joint mobility, pain and redness. In the blood results, if there is purulent arthritis in the body, the doctor will find an increased ESR, a high concentration of leukocytes and C-reactive protein.

When examining synovial fluid, the doctor examines the level of leukocytes with segmented neutrophils. If their indicator is about 50 thousand per 1 ml, then the diagnosis of “purulent arthritis” is confirmed. X-rays can reveal swelling of soft tissues, narrowing of joint gaps, and erosive destruction. Using ultrasound, the doctor examines the synovium.

To confirm the diagnosis, you may need to consult a rheumatologist, infectious disease specialist, gastroenterologist, pulmonologist and therapist.

The diagnosis is made on the basis of a characteristic history, clinical manifestations, and blood tests confirming the presence of acute inflammation

Treatment of infectious arthritis

The primary treatment for arthritis of any type is pain relief

,
antibiotic therapy and
,
of course
,
fever reduction
.

In order to achieve the most effective results, both medicinal and non-medicinal methods can be used as treatment.

All
measures
included in the treatment plan for various types of arthritis
are determined exclusively by the attending physician
, based on the results of a diagnostic examination. In most cases, treatment of infectious joint inflammation is carried out inpatiently.

IMPORTANT! Self-medication can cause the situation to worsen and the consequences to become irreversible.

Physiotherapy as a method of treating infectious arthritis

Physiotherapy

is a unique treatment that can be used both at the treatment stage and for rehabilitation purposes after radical measures.

Among the most effective measures it is customary to highlight:

magnetic therapy;
use of amplipulse or sinusoidally modulated currents;
electrophoresis (introduction of drugs into joint tissues through exposure to electric current);
laser or ultrasound therapy;
local exposure to paraffin or ozone.

Massage as a method of treating infectious arthritis

Massage

– a great way to improve/restore blood circulation to the affected joint. Despite its usefulness, you should resort to this method only after consultation with your doctor.

To treat various types of arthritis, the following types of massage can be used:

local
– concentrated on a specific area of the human body;
general
– the use of massage techniques is distributed throughout the body.

It is important to note that massage cannot be the only treatment for arthritis.

. Only an integrated approach, involving the use of drug treatment in tandem with physiotherapeutic methods, massage and specialized exercises, can give a chance for complete tissue restoration and elimination of the symptoms of the disease.

Exercise therapy as a method of treating infectious arthritis

Physiotherapy

– a special method of treating arthritis of various types, in particular those caused by infectious diseases.

Various types of exercises and static positions are an effective means of not only treating, but also preventing diseases of joint tissues.

Symptoms

With primary damage, pain, swelling, and hyperemia are observed in the first days. The condition quickly worsens, the “jerking” pain intensifies at night. The temperature rises. After 1-2 days, pockets of fluctuation (fluid accumulation) form.

With secondary infection, the disease develops gradually. A slightly painful focus of fluctuation forms in the area of the affected area. Fever and signs of intoxication are often absent. Further, the pathology proceeds as during primary infection.

Use of drugs in the treatment of infectious arthritis

Drug therapy in the treatment of arthritis is a fairly effective method that has the desired effect on the patient’s body. In case of timely application of a well-chosen treatment plan, it can be stated that the prescribed therapy is successful

As part of treatment, taking into account the causes and characteristics of the course of the disease, various types of antibiotics

, as well as other groups of drugs. Let's look at some of them in detail.

Chondroprotectors in the treatment of infectious arthritis

Chondroprotectors

- This is a group of long-acting drugs, the use of which is necessary for several months.

Prescribing a course of drugs of the presented type allows you to create favorable conditions for the restoration of articular tissues, which significantly affects the patient’s quality of life, due to the restoration of the functionality of the affected joint

The most effective drug of the group of chondroprotectors is considered to be “ Structum”

».

Antispasmodics in the treatment of infectious arthritis

Use of antispasmodics

provides the opportunity to relieve patients from muscle pain that occurs as a result of joint damage.

Among the frequently prescribed ones, it is worth highlighting “ Drotaverine

».

Nonsteroidal anti-inflammatory drugs in the treatment of infectious arthritis

Nonsteroidal anti-inflammatory drugs

(NSAIDs) are excellent helpers in the treatment of arthritis. The action of drugs of this type allows the patient to get rid of pain.

The frequency, duration of use and dosage are determined by the attending physician, based on the existing clinical picture.

One of the most effective drugs of this type is “ Artradol

».

Fungal

Most often, fungal infections of the joints develop with actinomycosis, but they also occur with other fungal infections. Pathogenic fungi enter the joint cavity from a nearby bone lesion or from distant lesions (carious teeth) through the bloodstream. The course is chronic, with relapses and the possible addition of a bacterial infection. Very often, fistulas occur - passages through which pus from the joint is released onto the surface of the skin. In the absence of adequate treatment, it leads to a gradual loss of joint function.

Parasitic

The cause of arthritis is usually echinococcosis, which affects the bone tissue of the vertebrae, pelvic bones and long bones of the limbs. A toxic-allergic inflammatory process usually develops in the joints. The joints of the spine, hips, knees and elbows are often involved. The course is benign, but is accompanied by severe joint pain. Recovery occurs when complete treatment of echinococcosis is prescribed.

Infectious-allergic arthritis

Infectious-allergic arthritis occurs when there is an allergy, against the background of which an inflammatory process in the joints develops under unfavorable conditions. The disease occurs in a violent form, accompanied by high fever and severe pain. Redness, swelling, and swelling are observed in the affected area. On different parts of the skin there is a ring-shaped allergic rash. Infectious-allergic arthritis is treated by a rheumatologist and an allergist.

Surgical method of treatment

In a situation where complex therapy is unable to cope with the existing degree of damage to the joint, radical methods come to the rescue, including surgery.

Surgical treatment of arthritis is used only in severe cases. Among the types of surgical intervention there are such measures as:

arthroscopy
is a low-traumatic operation that involves the removal of bone processes;
endoprosthetics
– replacement of articular elements with implants;
arthrodesis
– absolute fixation of the joint;
osteotomy
- excision of part of the bone tissue of the affected joint in order to reduce pressure on it;
arthroplasty
is a complete replacement of the affected joint.

What is acute bursitis

A person has about one hundred and sixty joint capsules (bursae). This is a special formation of strong connective tissue on the outside and a special layer of cells on the inside. Their task is to protect joints from external influences, injuries and friction of articular elements against each other. This is ensured with the help of a special synovial fluid, which is produced in the joint and improves gliding. In addition, it is this liquid that contains components that penetrate the cartilage tissue and provide its nutrition and hydration.

When the bursa becomes inflamed, the amount of fluid in it increases and its composition changes. Protein exudate, inflamed cells appear in the lubricating fluid, swelling of the joint capsule occurs - formation up to 5-10 cm in size. This leads to impaired mobility - any movement causes pain in the affected joint, and sometimes it bothers you even without physical activity.

The initial inflammation that occurs is acute bursitis. Typically, it occurs with severe symptoms that gradually decrease (with the exception of purulent bursitis). Untreated inflammation can lead to complications - the formation of purulent fistulas, phlegmon and tissue sepsis. Protracted acute bursitis becomes a chronic form of the disease. In this case, bursitis can worsen whenever immunity decreases or there are other risk factors for relapse. Chronic bursitis will be more difficult to cure.

Forecasts and prevention of infectious arthritis

Considering the prognosis of the disease, it is worth noting that only one third of patients with arthritis of infectious origin at the end of treatment are faced with unpleasant residual effects, which are expressed by joint immobility.

The most dangerous types of the disease are septic arthritis, because despite fairly favorable prospects, the fatal outcome is 5-15%

The risk group for developing infectious arthritis includes people of different ages who have ailments such as:

rheumatoid arthritis;
osteoarthritis;
bad habits;
weakened immune system;
obesity of varying degrees.

For the purpose of prevention, it is recommended to follow the basics of dietary nutrition, attend prescribed therapeutic events, promptly treat existing diseases and, of course, monitor the general health of the body.

General clinical recommendations

People with arthritis should:

to refuse from bad habits;
lead a healthy lifestyle, regularly take walks in the fresh air, toughen up;
do therapeutic exercises, swimming;
exclude heavy physical activity, injuries, stress;
eat right, watch your weight;
promptly treat all acute and chronic diseases;
continue to be observed by your doctor, undergo prescribed examinations and, if necessary, anti-relapse treatment.

These recommendations are also relevant for people suffering from chronic arthritis, especially rheumatoid arthritis.

Prevention

To prevent the development of purulent arthritis, it is worth following all the recommendations for a healthy lifestyle, hardening and doing sports as much as possible.

Recommendations for infectious arthritis

To maintain the effectiveness of therapy, as well as achieve the most favorable results, it is important to follow a number of recommendations for infectious arthritis, including:

Movement is an integral part of therapy.
Maximum limitation of sudden movements and forces that create additional stress on the affected joints.
Improving power sensations.
Simplifying everyday processes through the use of modern technological solutions.
Increasing personal safety by installing additional handrails in the apartment, using anti-slip mats, etc.

How dangerous is the disease?

The course of the pyogenic inflammatory process in the joints depends on the virulence (ability to cause harm to the patient’s body) of the infectious agent, the state of the patient’s immunity, and the presence of chronic diseases. Without treatment, the disease progresses in any case, moving from stage to stage with joint destruction and severe complications.

Stages

Stages of pyogenic arthritis according to the Research Institute named after. Vishnevsky:

Early
– pus accumulates in the joint cavity without destroying its tissues (on x-rays, an expansion of the joint space appears due to the accumulation of purulent exudate):
1b
– purulent inflammation around the joint.
Explicit
– intra-articular tissues (synovium, cartilage, ligaments) are destroyed (on x-ray - destruction of the articular surfaces of bones):
2b
– suppuration spreads to surrounding tissues.
Progressive
– cartilage and subchondral bone are destroyed (on x-ray – focal bone destruction, narrowing of the joint space), joint mobility is impaired:
3b
– ulcers around the joint;
3c
– fistulas (pus breakthrough) on the surface of the skin.
Ultimate
:
If treatment is carried out in a timely manner
, a complete recovery is possible.

Possible complications

Any form of arthritis has serious complications, so you should not delay treatment.
See how easily the disease can be cured in 10-12 sessions.

If left untreated, suppurative processes lead to severe complications:

complete destruction and immobility of the joint;
spread of suppuration to the skin, subcutaneous tissue, ligaments and tendons with the formation of fistulas, abscesses and phlegmons that are difficult to treat;
osteomyelitis – purulent inflammation of the bone;
compression of nerves by swollen tissues, accompanied by severe pain; for example, ankle arthritis may be complicated by tarsal syndrome due to compression of the tibial nerve;
sepsis – multiple pyogenic lesions of organs and systems.

Pyogenic arthritis is a disease that cannot be cured with home remedies. The sooner the patient sees a doctor, the greater his chances of recovery.

What to do if you suspect purulent arthritis

Algorithm of actions:

call a doctor at home; if you have a high temperature, call an ambulance;
take any medicine with anti-inflammatory and antipyretic effects: Analgin, Pentalgin, Paracetamol, Diclofenac; Apply an external agent with similar properties to the affected joint: Diclofenac ointment, Menovazin solution;
lie down and take a position that minimizes pain.

Do not refuse hospitalization under any circumstances!

Features of nutrition during treatment and prevention of infectious arthritis

Therapeutic nutrition for arthritis of various types is aimed primarily at normalizing the immune response, as well as weakening inflammatory processes, in order to restore the range of motion of the affected joint.

Nutritional features depend on:

stages of disease development;
presence of concomitant diseases;
severity of clinical manifestations.

Based on this, we can come to the conclusion that there is no single diet. However, there are a number of general principles for creating a diet, including:

fractional meals;
preference for certain types of culinary food processing (boiling/baking/steaming/stewing);
food intake temperature – no more than 60°C;
limiting salt and liquid intake;
giving up bad habits;
saturating the diet with vitamins.

Definition

Purulent arthritis is a serious disease that is an inflammation of all joint structures. The peculiarity of this type of arthritis is that the joint is a closed cavity. This anatomical structure of the joint creates “favorable” conditions for the accumulation of purulent contents. The joint cavity is equipped with lymphatic and blood vessels, which can lead to the spread of infection throughout the body.

This form of arthritis requires timely diagnosis and treatment, since the purulent process affects all components of the joint.

The danger of purulent arthritis lies in its consequences. A negligent attitude towards one's health can lead to the development of sepsis, ankylosis (complete immobility of the joint), arthrosis, and joint deformation. To avoid serious complications, you should listen carefully to your body.

Purulent arthritis - inflammation of all joint structures caused by pyogenic microflora