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Arthritis, Septic

Ravishankar E Rao, MD Reviewed 06/2022
 


BASICS

DESCRIPTION

  • Infection due to bacterial invasion of the joint space

  • Systems affect: musculoskeletal

  • Synonyms: suppurative arthritis; infections arthritis; pyarthrosis; pyogenic arthritis; bacterial...

DIAGNOSIS

HISTORY

  • Typically presents with a combination of joint pain, swelling, warmth, and decreased ROM

  • Non-gonococcal arthritis: mostly monoarticular (80%)

    • Typically large joints: knee (50%), hip (20...

TREATMENT

GENERAL MEASURES

  • Admit for parenteral antibiotics and monitoring.

    • Begin antibiotics immediately after arthrocentesis.

  • Drainage of purulent material is required if:

    • Pediatric: Surgical drainage a...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Can monitor synovial fluid to verify decreasing WBC and sterile fluid after initial treatment

  • If not improvement in 24 hours, re-evaluate and con...

REFERENCES

1
Long B, Koyfman A, Goggleib M. Evaluation and Management of Septic Arthritis and its Mimics in the Emergency Department. Western Journal of Emergency Medicine. 2019; 20(2):331-341.
2
Carpent...

ADDITIONAL READING

  • Hassan AS, Rao A, Manadan AM, et al. Peripheral bacterial septic arthritis: Review of diagnosis and management. J Clin Rheumatol. 2017;23(8):435-442.

  • ...

CODES

ICD10

  • M00.079 Staphylococcal arthritis, unspecified ankle and foot

  • M00.829 Arthritis due to other bacteria, unspecified elbow

  • M00.011 Staphylococcal arthritis, right shoulder

  • M00.261 Other streptoco...

CLINICAL PEARLS

  • Arthrocentesis and synovial fluid analysis are mandatory in cases of suspected septic arthritis.

  • Gram stain has variable sensitivity in septic arthritis. sWBC count is generally >50,...

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