Treatment is usually with intravenous antibiotics, analgesia and washout and/or aspiration of the joint. Draining the pus from the joint is important and can be done either by needle (arthrocentesis) or opening the joint surgically (arthrotomy). Empiric antibiotics for suspected bacteria should be started. This should be based on Gram stain of the synovial fluid as well as other clinical findings. General guidelines are as follows: * Gram positive cocci – vancomycin * Gram negative cocci – Ceftriaxone * Gram negative bacilli – Ceftriaxone, cefotaxime, or ceftazidime * Gram stain negative and immunocompetent – vancomycin * Gram stain negative and immunocompromised – vancomycin + third generation cephalosphorin * IV drug use (possible pseudomonas aeruginosa) – ceftazidime +/- an aminoglycoside Once cultures are available, antibiotics can be changed to target the specific organism. After a good response to intravenous antibiotics, people can be switched to oral antibiotics. The duration of oral antibiotics varies, but is generally for 1–4 weeks depending on the offending organism. Repeated daily joint aspiration is useful in the treatment of<unk> . Every aspirate should be sent for culture, gram stain, white cell count to monitor the progress of the disease. Both open surgery and arthroscopy are helpful in the drainage of the infected joint. During surgery, lysis of the adhesions, drainage of pus, and debridement of the necrotic tissues are done. Close follow up with physical exam & labs must be done to make sure the person is no longer feverish, pain has resolved, has improved range of motion, and lab values are normalized. In infection of a prosthetic joint, a biofilm is often created on the surface of the prosthesis which is resistant to antibiotics. Surgical debridement is usually indicated in these cases. A replacement prosthesis is usually not inserted at the time of removal to allow antibiotics to clear infection of the region. People that cannot have surgery may try long-term antibiotic therapy in order to suppress the infection. The use of prophylactic antibiotics before dental, genitourinary, gastrointestinal procedures to prevent infection of the implant is controversial. Low-quality evidence suggests that the use of corticosteroids may reduce pain and the number of days of antibiotic treatment in children.
Septic arthritis
Osteoarthritis
Knee arthritis
Gout
Compression arthralgia
Rheumatoid arthritis
Inflammatory arthritis
Reactive arthritis