Can you give me a quick tutorial on the difference between osteomyelitis and septic arthritis of the wrist and hand? My sister has been diagnosed with septic arthritis (she also has rheumatoid arthritis) but they said it could become osteomyelitis.
Osteomyelitis is an infection of the bone or bone marrow that can affect the hand. The most common infecting bacteria are staph, strep, and e coli. How does a person get osteomyelitis of the hand or wrist? There are three main mechanisms: 1) puncture wounds (e.g., human bites, thorns, fractures, and surgery), 2) spread from infection of nearby soft tissues, and 3) spread through the blood system from any other infection in the body.
The difference between osteomyelitis and septic arthritis is location. Remember, osteomyelitis is a bacterial infection of the bone or bone marrow. Septic arthritis is an overgrowth of the same bacteria only in the joint instead of in the bone.
Causes of septic arthritis of the wrist and hand are similar to osteomyelitis of the same areas: trauma (knife wound, human bites, or face punch with puncture by the teeth) and spread from some other nearby location. Staph infections are the most common cause of septic arthritis but joint infections can also be caused by a bacteria called pseudomonas.
Patient factors that increase the risk of septic arthritis include: rheumatoid arthritis (your sister's situation), alcohol abuse, diabetes, steroid therapy, injection drug abuse, and chronic kidney or liver failure.
When the immune system gets word that there is a bacterial infection of the joint, it launches an immediate anti-inflammatory response. If unsuccessful, septic arthritis can eat its way through the joint to the bone then causing osteomyelitis (of the bone next to the septic joint).
Patricia McKay, MD, MC, USN, et al. Osteomyelitis and Septic Arthritis of the Hand and Wrist. In Current Orthopaedic Practice. November/December 2010. Vol. 21. No. 6. Pp. 542-550.
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