Musculoskeletal infections

Bone infection – Osteomyelitis

Infections can get to the bone either by traveling through your bloodstream or spreading from tissue around it. An infection may travel to the bone from skin or muscles nearby, or it can travel through the bloodstream from another part of the body. Bacteria or other germs can spread to a bone from the infected skin, muscles, or tendons near the bone.

Osteomyelitis means an infection in bones, that may be either acute (recently occurring) or chronic (long-lasting). Osteomyelitis of the bones can be caused by bacteria, a fungus, or another germ.

Depending on the infection type and the patient, osteomyelitis can cause multiple symptoms like pain, fever, joint swelling, muscle ache, difficulty walking or generalised weakness. In children it can affect the growth of the child.

Management of bone infection is extremely challenging and requires input from different specialists. For this reason, Dr Darshan Angadi works with a multi-disciplinary team (MDT) consisting of microbiologist, plastic surgeon, pathologist and pain specialists to name a few to provide the best and latest evidence-based treatments for patients with bone infections.

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Joint infection – Septic arthritis

Septic arthritis is an infection of the fluid of your joints, also known as the synovial fluid, and your joint tissues. Bacteria, fungi, or viruses are able to infect joints, though septic arthritis is generally used to describe nonviral causes of joint infections, usually caused by bacteria. Most cases of septic arthritis involve a single organism; however, polymicrobial infections may occur, particularly following a large, open wound to a joint. 

Septic arthritis may develop when an infection, such as a skin infection or urinary tract infection, spreads through the bloodstream into the joint. In rare cases, an infection in the bone may spread to the adjacent joint, leading to septic arthritis. If septic arthritis occurs in a prosthetic joint (prosthetic joint infection), signs and symptoms, such as mild pain and swelling, can occur months to years after undergoing knee replacement or hip replacement surgery. Symptoms of septic arthritis vary among children, and they can differ depending on what joint is affected, how old the child is, and what kind of organism causes the infection.

If the individual does not get prompt, strong treatment, infectious arthritis can result in permanent damage to joint tissues and bones. Therefor specialist advise and review is required to manage septic arthritis as this is an emergency.

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Skin infection – Cellulitis

Cellulitis is a bacterial skin infection that may result in symptoms like pain, swelling, and redness. Normal skin may be affected by cellulitis, but usually happens after a certain type of injury causes the skin to break down, including injury or surgery. In general, injuries like cuts, sores, animal bites, or surgical sites place an individual at risk of developing cellulitis. 

Symptoms Cellulitis typically begins as a puffy, pink, or reddish area of skin, which can grow in size and severity as the infection spreads. If left untreated symptoms can progress rapidly and cause severe systemic complications.

Necrotising fasciitis is a form of skin and soft tissue infection that spreads very rapidly and can damage the underlying structures permanently.

Hence prompt intervention from an expert to accurately diagnose the type of skin / soft tissue infection is crucial to prevent long term complications.

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Prosthetic joint infection

A prosthetic joint infection, also called prosthetic joint infection or PJI, is an infection that sets in after a patient has undergone surgery to replace a natural joint with an artificial one.

When a person undergoes surgery to replace the natural joint with an artificial one, it’s usually because the natural joint can no longer support their weight or perform its usual functions. However, this leaves them susceptible to complications like prosthetic joint infections. 

 

Even though prophylactic antibiotics are used to prevent infection during surgery, in some cases they cannot stop it. The most common type of prosthetic joint infection is an infected hip or knee implant.
When this happens, your body responds with inflammation and redness around the implant. If it’s not treated quickly and correctly, PJI can be a serious condition that can even lead to amputation in some cases.

There are two types of prosthetic joint infections: primary and secondary. Primary means it occurs soon after surgery and is more likely in people with type 2 diabetes, obesity, smoking, high blood pressure, and steroids. Secondary Prosthetic joint infection occurs later and is more common than primary PJI as it develops from other conditions such as cellulitis or septic arthritis that may have been present before surgery.

If undetected or neglected, PJI may have serious consequences such as bone destruction, need for revision surgery and even risk of amputation. Hence a comprehensive and complete assessment from experts like Dr Darshan Angadi is crucial to identify PJI and commence the correct treatment as per latest scientific techniques of revision surgery, custom implants and 3D printed implants to provide good outcomes for patients.

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