Septic arthritis after steroid injection

To your points:
1) Yes, GC does cause monoarticular arthritis… but if you see polyarticular in a sexually active patient, think GC as #1 cause. Actually… if they are sexually active… thinking GC is a righteous plan.
2) 100% concur that Kocher Criteria are over-rated. If fact, that was part of my point. That being noted, they are often referred to by our consultants and it is, therefore, important for us to know what they actually say. The fact that the original paper argues that having 2 criteria deserves attention is often lost in translation, particularly when everyone wants to focus on the lab values. 2 of those criteria are not lab values… so if the patient has fever and won’t bear weight, then the original paper argued they were at risk. Well, those are the two criteria that often start the conversation in the first place. Thus, it requires our pre-test probability and vigilance to determine whether we should pursue the diagnosis and having “normal” labs should not diminish our concerns.
3) Also concur that MRI is more sensitive and specific than U/S; however, U/S may help in cases where the diagnosis is still being debated.

() A 10-month-old infant is brought to the emergency department for fevers, irritability, and avoidance of motion in the right leg. On physical exam, passive motion of the right hip elicits crying. An AP pelvis and an ultrasound of the right hip are shown in Figures A and B respectively. A hip aspiration yields 82,000 WBC with > 80% PMNs. Which of the following is the strongest predictor of a poor prognosis? Review Topic

If hemoglobin levels fall below 7 g/dL, red blood cell (RBC) transfusion is recommended to a target hemoglobin range of 7-9 g/dL. [ 11 ] Even in the absence of apparent bleeding, patients with severe sepsis should receive platelet transfusion if platelet counts fall below 10 × 10 9 /L (10,000/µL). Platelet transfusion may also be considered when bleeding risk is increased and platelet counts are below 20 × 10 9 /L (20,000/µL). [ 11 ] Patients who are to undergo surgery or other invasive procedures may require higher platelet counts (eg, ≥50 × 10 9 /L [50,000/µL]).

Patients with disseminated Neisseria gonorrhoeae infection are usually young, healthy, and sexually active. 30 Disseminated gonococcal infection may have various clinical musculoskeletal presentations, with or without associated dermatitis. Patients typically display a migratory pattern of arthralgias, tenosynovial inflammation, or nonerosive arthritis. 6 , 23 , 30 Blood cultures are seldom positive, and synovial fluid cultures are variable, with a positive result in only 25 to 70 percent of patients with gonococcal arthritis. 19 , 23 When a disseminated gonococcal infection is suspected, cultures should be taken from potentially infected mucosal sites (., urethra, rectum, pharynx, cervix). 30 , 41 PCR testing has a sensitivity of 76 percent and a specificity of 96 percent for N. gonorrhoeae , and may be useful in patients with culture-negative disease if the clinical scenario is unclear or similar to a reactive arthritis. 26

Septic arthritis after steroid injection

septic arthritis after steroid injection

Patients with disseminated Neisseria gonorrhoeae infection are usually young, healthy, and sexually active. 30 Disseminated gonococcal infection may have various clinical musculoskeletal presentations, with or without associated dermatitis. Patients typically display a migratory pattern of arthralgias, tenosynovial inflammation, or nonerosive arthritis. 6 , 23 , 30 Blood cultures are seldom positive, and synovial fluid cultures are variable, with a positive result in only 25 to 70 percent of patients with gonococcal arthritis. 19 , 23 When a disseminated gonococcal infection is suspected, cultures should be taken from potentially infected mucosal sites (., urethra, rectum, pharynx, cervix). 30 , 41 PCR testing has a sensitivity of 76 percent and a specificity of 96 percent for N. gonorrhoeae , and may be useful in patients with culture-negative disease if the clinical scenario is unclear or similar to a reactive arthritis. 26

Media:

septic arthritis after steroid injectionseptic arthritis after steroid injectionseptic arthritis after steroid injectionseptic arthritis after steroid injectionseptic arthritis after steroid injection

http://buy-steroids.org