Skip to main content

Arthritis, Septic

Jeffrey P. Feden, MD, FACEP Reviewed 06/2020
 


BASICS

DESCRIPTION

  • Infection due to bacterial invasion of the joint space

  • Systems affected: musculoskeletal

  • Synonyms: suppurative arthritis; infectious arthritis; pyarthrosis; pyogenic arthritis; bacteri...

DIAGNOSIS

HISTORY

  • Typically presents with a combination of joint pain, swelling, warmth, and decreased range of motion.

  • Nongonococcal arthritis: mostly monoarticular (80%)

    • Typically large joints (knee ...

TREATMENT

GENERAL MEASURES

  • Admit for parenteral antibiotics and monitoring. Begin antibiotics immediately after arthrocentesis.

  • Drainage of purulent material is required if:

    • Pediatric: Surgical drainag...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

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

  • If no improvement within 24 hours, reevaluate and c...

REFERENCES

1
Mathews CJ, Weston VC, Jones Aet al. Bacterial septic arthritis in adults. Lancet.  2010;375(9717):846–855. [View Abstract on OvidMedline]
2
Ross JJ. Septic arthritis of native joints. ...

ADDITIONAL READING

Hassan AS, Rao A, Manadan AMet al. Peripheral bacterial septic arthritis: Review of diagnosis and management. J Clin Rheumatol.  2017;23(8):435–442. [View Abstract on OvidMedli...

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,...

Subscribe to Access Full Content

Sign Up for a 10-Day Free Trial

Sign up for a 10-day FREE Trial now and receive full access to all content.

×