Joint washout for septic arthritis

Septic arthritis is an infection of a joint, most often the knee, hip or shoulder. Germs reach the joint through the bloodstream, after an injection, a wound or an operation. The joint suddenly becomes very painful, swollen and warm, and fever is common. It is an emergency: without prompt treatment, the cartilage can be destroyed within a few days. Diagnosis relies on aspirating the joint: the fluid removed is analysed to identify the germ. Treatment combines antibiotics with a washout of the joint, which clears the pus and the germs. The washout is most often done by arthroscopy: the surgeon inserts a camera and rinses the joint thoroughly with saline, removing the infected deposits. Open surgery is sometimes needed, particularly for the hip or when the infection is advanced. A second washout may be required if the infection persists. Infection of a joint replacement needs specific management, discussed with the surgeon. At Clinique Pasteur Tunis, patients are received in the emergency department and the operation is organised promptly by the orthopaedic team, working with physicians on the choice and duration of antibiotics.