<prompt> All are true about septic arthritis except:Staph. Aurreus is most common causative organismCommon in childrenAffect growth plateE.coli is the commonest causative organism  <response>: Ans: D E.coli is... Complication: Damage to the cartilaginous physts or the epiphysis in the growing child is the most serious complication. Sequelae include retarded growth, partial or complete destruction of epiphysis, deformity of the joint, epiphyseal osteonecrosis, acetabular dysplasia psuedoarthrosis of the hip- Apiey 9th45Aspirate the joint examine the fluid. .4 WBC gram stain should be carried out immediately. Sample of fluid are also sent for full microbiological examination tests for antibiotic sensitivity- Apiey 9th44SEPTIC ARTHRITIS Maheswari 5th175-78; 3rd163It is more common in children males are more susceptible. Stcrpiyocoocus aureus is the commonest causative organism, other organisms are strepto- pneumo Gonococcus.The organism reach the joint by one of the following routes-Haematogenous: This is the commonest routeSecondary to nearby osteomyelitis: This is a particularly common route in joints with intra-articular metaphysicPenetrating woundsIatrogenicUmbilical cord sepsisPATHOGENESIS Nelson 18th2846Suppurative arthritis primarily occurs as a result of hematogenous seeding of the synovial space. Less often, organisms enter the joint space by direct inoculation or extension from a contiguous focus.The synovia membrane has a rich vascular supply and lacks a basement membrane, providing an ideal environment for hematogenous seeding. Table Maheswari 5th177: Synovial joint examinationPointsNormalNon-inflammatoryInflammatorySepticGross examination Volume mlOften 3.5 mlOften 3.5 mlOften 3.5 ml 3.5 ml Viscosity Colour ClarityHighColourlessTransparentHighStraw yellow TransparentLowYellowTranslucentVariableVariableOpaqueExamination in lab. WBC count PMN leucocytes Culture Mucin clot Glucose level20025-FirmEqual to blood glucose200-200025-FirmNearly equal to blood glucose2000-7500 50-Friable25 mg. of blood glucose1000075Friable25 mg of blood glucose Crystal examination: Positive in Gout-Sodium biurate.Positive in Pseudogout-Ca pyrophosphate 