Houston Methodist. Leading Medicine

Wrist FAQ

Question:

I feel like I'm in a grade B horror film. In one year, I was diagnosed with breast cancer, had chemotherapy, and then developed a staph infection from cellulitis. They think I got the cellulitis from the intravenous catheter used to give me a blood transfusion after surgery for the cancer. Now I've developed septic arthritis of the wrist from the staph infection. What's the prognosis for that?

Answer:

Septic arthritis is the invasion of a joint by an infectious agent that produces arthritis. It can affect any of the joints in the body but has a tendency to settle in the large joints. This includes the hip, knee, and shoulder. The infectious agent starts someplace else (often a skin infection like cellulitis or from a urinary tract infection. It travels to the joint directly by local spread or through the blood system. Risk factors for septic arthritis include joint replacement, cancer, kidney failure, or other chronic diseases. For example, chronic alcoholism, diabetes, rheumatoid arthritis, or other connective tissue disorder have been linked with septic arthritis. Taking medications that can suppress the immune system (e.g., prednisone, other immune modulators such as current or recent chemotherapy) is another potential risk factor for developing septic arthritis. Treatment is with intravenous antibiotics and surgery. The surgical procedure is called irrigation and débridement. That means once the surgeon gets to the area of infection (either through an open incision or arthroscopically), saline fluid is used to flush the area clean (irrigation). In a second step (débridement), any fluid and any loose tissue or fragments of cartilage is removed. There are some potential complications of surgery. Sometimes the infection is not stopped successfully and a second surgery is required. It's also possible that more than one repeat procedure will be needed. After surgery, the pain is often gone, but normal joint movement isn't always restored. One distressing complication is death. Septic arthritis can lead to sepsis and multisystem organ failure. Sepsis refers to total body infection. People who have septic arthritis in multiple joints, who have other significant (chronic) health problems, and who are immunosuppressed are at greatest risk for sepsis. But lest we leave you with such a grim picture, treatment for single joint involvement (just the wrist) can be very successful. Arthroscopic surgery reduces the length of hospital stay and thereby reduces your costs as well. Douglas M. Sammer, MD, and Alexander Y. Shin, MD. Comparison of Arthroscopic and Open Treatment of Septic Arthritis of the Wrist. In The Journal of Bone and Joint Surgery. June 2009. Vol. 91A. No. 6. Pp. 1387-1393.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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