Septic Arthritis Assessment 2022

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Name of the Student
Name of the University
Author Note

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Introduction
A 37 year old woman was diagnosed with symmetric arthritis and it has been found that
her body has an autoimmune problem. The factor also highlights that she has rheumatoid factor
present in her blood that leads to the factor of the rheumatoid arthritis (RA). Hence, the doctor
told her that she needs knee replacement however; she was infected with bacteria and her knee
suddenly got swollen and purulent synovial fluid was flowing out of the infection. All these
factors highlight the autoimmune problem of the person and the need of the proper assessment of
the disease and the treatment as well. Hence, the analysis of the factors of the pathophysiology of
the symptoms is required. In the following section the pathophysiology and the possible causes
of the disease would be described along with the proper analysis and the factors that can be able
to address the issue.
Discussion
Understanding
The woman was diagnoses with rheumatic arthritis after the X-ray and it has been seen
that the poor response to the anti-rheumatic drugs and the she became more disabled as her knee
joints are changing in a more vulnerable state. The disease modifying anti-rheumatic drugs
(DMARDS) failed to have any effect over the disease of the patient as her immune system is not
responsive or the proper effect of the DMARDS are masked by the adverse and dynamic changes
occur in the body and this factor can be able to affect the bone marrow of the patient (Genovese
et al., 2018). In order to counter these factors the patient was prescribed with prednisolone, a
steroid in her age of 42 and it has been seen that her body response to it in a better way and her
joints are improving in terms of adverse symptoms (Shilpakar, Lemperle, Mentzel, Shakya &

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Bhandari, 2017). However, one month prior to the knee replacement surgery she has been
admitted to the emergency department with swollen right knee. Purulent synovial fluid was taken
from the swollen joint and the microscopic diagnosis of the fluid highlighted that her body was
infected with Gram positive Staphylococcus aureus. It can be stated that as her immune system is
not responsive and the autoimmune system is very much active thus her body could not be able
resist the attack of the S. aureus bacteria and the body got infected by the foreign infectious
microorganism. As the synovial joint consists of the synovial fluid that is the extracellular fluid
and it contains the proteins of the blood plasma, it is one of the obvious targets of the
microorganisms. Hence, it can easily be stated that the synovial layer of the joint got affected by
the S. aureus as the immune system of the body is not properly working and the synovial fluid
consists a large amount of nutrition for the microorganism growth. Hence, the patient was
prescribed with antibiotics for at least six weeks and also with physiotherapy in order to help her
knees to sustain against the problem. However, it has been found that her knee condition worsens
than before and there was no effect which leads to her physical betterment. Hence, on the
discussion it can be said that her immune system is not specifically responding towards the
antibiotic response and the condition of her autoimmune responses also the factor that affect the
rheumatic arthritic condition (Singh et al., 2016). Hence, it is needed to be checked and the
counter measure should be implemented for preventing the autoimmune responses of the body of
the patient. The rheumatic arthritis is the issue that also needed to be addressed with a high
priority in order to cure the patient’s condition. However, the factor of the septic condition lead
to the septic arthritis of the knee joint which made her disabled day by day. Hence, the proper
implementation of the treatment for the supplementation of the immune system and the
elimination of the septic arthritis would be needed. Hence, the patient must be provided with

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proper physiological treatment and also should be moving as the long time of leisure can cause
sore or higher amount of pain in the knee joints. Such implementations also have barriers in this
case as the increasing amount of tension within the layer of the knee joint can also increase the
chances of the severe damage to the bones as the friction of the bones cannot be checked by the
synovial fluid of the joint in case of the septic condition developed due to the infection of the S.
aureus.
Analysis
On the basis of the above discussion it can be seen that the patient was experiencing
severe pain in her knee thus she was not been able to straighten her legs and could not walk for a
while as well. Hence, the scenario of the patient indicates the fact of the immunization problems
that it can be cured if the person was treated with an early diagnosis. However, in case of the age
the person’s immunity system was very weak as her autoimmune system was affecting the
immunity system of the body. The rheumatic factor that is the autoimmune system of the body
was very much active that it affects the own body tissues as the rheumatoid factor primarily
attack the Fc part of the IgG antibody. Hence, the non-recognition of the own body tissues and
affecting different tissues lead to the rheumatoid arthritis. The can be related to the factor of the
autoimmune disability of the patient. Whole scenario leads to the septic arthritis of the patient
that can be stated as the result of the rheumatoid factor affecting her body. The factor of the low
immunity of the patient against the microbial infection leads to the septic arthritis and the
synovial layer and the fluid got infected with S. aureus. The aspect of the rheumatoid factor
attacking the Fc portion of the IgG affects the immune system of the body by involving the
immune system in internal actions. Hence, the septic arthritis can be classified as an autoimmune
disease as it is affected by the autoimmune disorder of the body (Masadeh, Hossain, Dunkelberg

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& Gerke, 2016). The aspect of the autoimmune disorder by the rheumatic factor can be triggered
by the genetic imbalance however; there is no evidence of the development of rheumatic arthritis
from the inheritance. Hence, the actual cause of the imbalance and the activation of the
rheumatic factor cannot be explained properly. Thus the need of the research on this context is
important and the understanding of the requirement of the proper treatment for the disease
control is also an important factor. Hence, the analysis of the causes of the rheumatic arthritis
and the relation of the septic arthritis would be effective in the proper treatment method
development. The pathophysiology of the septic arthritis of the patient can be stated as the
rheumatic factor that affects the process of the immune system and indulging the microbial
infection in the body. Hence, the process of the antibiotic treatment for supplementing the
immune system of the body can be implemented in a manner that can effectively prevent the
growth of the infection or the microbial colony in the blood stream of the body. However, in this
case the patient showed no improvement after implementation of the antibiotic treatment for six
weeks. Thus improved treatment process should be developed in order to sustain against the
specific autoimmune disorder of the body. The analysis and understanding of the case would be
helpful in the proper treatment idea development of the disease. The aspect of the increasing
disability of the patient could be related to the pain of the knee joint and the cause of the pain of
the patient is the infection in the synovial layer of the knee joint. On the other hand the response
of the body immune system against the sepsis formation in the right knee joint develops the
septic shock as well which also develops the pain. However, the rheumatic factor on the other
hand affecting the IgG antibody of the body thus the immune system weakens enough to attack
the foreign microbial colonies developed in the synovial layer of the knee joint. The
ineffectiveness of the antibiotic can be stated as the factor of the immunity development in the S.

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aureus. Hence, the counter measure should be developed in order to cure the patient and it can be
done with the help of implementing higher dose of antibiotic or different antibiotic that can be
effectively supplement the immune system of the patient (Böhler, Dragana, Puchner, Windhager
& Holinka, 2016).
Conclusion
On the basis of the above discussion it can be concluded that the proper evidence based
practice should be implemented for the treatment of the patient. The patient should be provided
with the proper treatment of the antibiotics and also provided with proper physiological activities
in order to eliminate the sore situations. However, the most effective treatment should be
researched with the help of the evidences. On the basis of the discussion and the analysis of the
case it can be reflected that the proper treatment should be implemented with the help of the
evidence based practice and proper medication.

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Referencing
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Smolen, J. S. (2018). SAT0237 Efficacy of baricitinib in patients with rheumatoid arthritis who
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Shilpakar, R., Lemperle, G., Mentzel, T., Shakya, J., & Bhandari, S. B. (2017). Unexpected
Effect of Propranolol and Prednisolone on Infantile Facial Rhabdomyosarcoma. Journal of
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