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Arthritis, Monoarticular, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

  • Localized to 1 joint, not migratory

  • 1 etiology does not exclude another

  • Infectious (septic) arthritis: Rapidly destructive process causes significant disability

    • Contiguous extension (ce...

Diagnosis

Early accurate diagnosis allows directed therapy, earlier resumption of function, activities of daily living (ADL); longer-term morbidity lessened 

Signs and Symptoms

  • Isolated to 1 joint, not ...

Treatment

Pre-Hospital

Alluding to subsequent headings containing all pertinent consideration. 

Initial Stabilization/Therapy

  • Joint immobilization, position of comfort

  • Vascular access for rapid, titratabl...

Follow-Up

Disposition

Admission Criteria

  • Unable to perform ADL

  • Evidence systemic illness, metabolic derangement (sepsis, DKA)

  • Any joint requiring surgical intervention (including serial washouts)

  • Intractab...

Pearls and Pitfalls

  • Joint aspiration with Gram stain of fluid is the most important aspect of securing a diagnosis, directing initial management

  • Suspect septic arthritis in the presence of Intra-articu...

Additional Reading

  • Carpenter  CR, Schuur  JD, Everett  WW, et al. Evidence-based diagnostics: Adult septic arthritis. Acad Emerg Med.  2011;18(8):781–796.

  • Genes  N, Chisolm-Straker  M. Monoarticul...

Codes

ICD9

  • 274.00 Gouty arthropathy, unspecified

  • 711.90 Unspecified infective arthritis, site unspecified

  • 716.90 Arthropathy, unspecified, site unspecified

ICD10

  • M00.9 Pyogenic arthritis, unspecified

  • M10.00...

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