Infective Arthritis

Tom Smith Arthritis affects

• Neck of infants

• Hip joint in infants

• Elbow joint in Children

• Shoulder joint in children

Answer explanation

Tom Smith arthritis is septic arthritis of hip in infants which may destroy the cartilaginous femoral head rapidly and completely (Chondrolysis). In early cases child presents with systemic symptoms like fever, irritability, acute onset of hip pain and refusal to walk.

In late cases child may present with destroyed hip joint resulting in limp, unstable gait, shortening of limb, telescopy, increased hip movements in all direction. at this stage treatment is directed to stabilize the hip

All are true about septic arthritis except

• Aspiration of joint fluid used for diagnosis

• E coli is the most common cause

• Common in children

• Affects growth plate

Tom Smith Arthritis is infectious arthritis destroying

• Femur neck

• Acetabular roof

• Greater trochanter

• Capital epiphysis of femur

In case of suspected septic arthritis, best way to confirm the diagnosis is

• Aspiration of joint

• CT Scan

• MRI scan

• Blood investigations

Which of the following is an orthopaedic emergency

• Intra-articular fracture

• Septic arrhritis

• Fracture lateral condyle of humerus

• Fracture neck of femur

Most common joint involved in septic arthritis is

• Knee

• Hip

• Shoulder

• Elbow

Answer explanation

Knee is most commonly involved joint in septic arthritis followed by hip, shoulder and ankle

Aspirated synovial fluid in septic arthritis will have

• Clear colour

• High viscosity

• Markedly increased polymorphoneuclear leucocytes

• None of the above

Deformity in septic arthritis of hip

• Abduction

• Flexion

• External rotation

• All the above

Septic arthritis is diagnosed by

• X Ray

• USG

• Joint aspiration

• MRI

A 4 y old child complains of high grade fever, decreased appetite and pain right hip. On examination he has dehydration, tenderness in Scarpa's triangle, swelling in right hip region, absent movements at right hip. On X ray there is mild increase in medial joint space. Diagnosis is

• Dislocation of hip

• Septic arthritis

• Transient synovitis

• Tubercular arthritis