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Septic Arthritis

(Bacterial Arthritis; Pyogenic Arthritis)

Definition

Septic arthritis is a serious infection of the joints caused by bacteria. The tissue of the joint reacts to the infection and fights the bacteria by filling the joint with pus and inflammation. This action can increase pressure in the joint, affect blood flow, and damage the joint structures, bone, and surrounding cartilage.

Causes    TOP

Septic arthritis develops when bacteria attaches to tissue in the joint and begins to spread. The infection may be started by bacteria:

  • That has entered the blood stream from an infection somewhere else on the body
  • That entered the bloodstream from IV drug use
  • That exists outside the body and entered through a wound, injury, or surgery to the area

Joint Damage in Knee

Knee arthitis
Copyright © Nucleus Medical Media, Inc.

Risk Factors    TOP

Septic arthritis can occur at any age, but it generally affects older adults and children aged 3 years old and younger.

Factors that may increase your chance of developing septic arthritis include:

Symptoms    TOP

In infants, the hip is a frequent site of infection. In toddlers, it is the shoulders, knees, and hips. In adults, it most commonly affects weight-bearing joints, such as the knees.

Symptoms may include:

  • Newborn or infants:
    • Crying when a joint is moved, such as during a diaper change
    • Inability to move the limb of a joint
    • Swelling and redness
    • Irritability
    • Fever
    • Persistent crying for any reason
  • Children and adults:
    • Intense joint pain
    • Joint swelling and redness
    • Fever
    • Chills
    • Inability to move a joint or its limb
    • Limping

Diagnosis    TOP

You will be asked about you or your child’s symptoms and medical history. A physical exam will be done. Your doctor may refer you to a specialist.

Bodily fluids may need to be tested. This can be done with:

  • Testing joint fluids
  • Blood tests

Images may be taken of your bodily structures. This can be done with:

Treatment    TOP

Antibiotic therapy is started as soon as a diagnosis is made. In the beginning, antibiotics are given by IV. This is to ensure that the infected joint receives medication to kill the bacteria. The specific medications used depend on the type of bacteria that is causing the infection. The remaining course of antibiotics may be given by mouth.

Fluid may be removed from the joint to reduce the likelihood of joint damage. This may be done either by placing a needle in the joint or through surgery.

Rest, preventing the joint from moving, and warm compresses may be used to manage pain. Physical therapy or exercises may also speed recovery.

Prevention    TOP

To help reduce your chance of getting septic arthritis, get prompt treatment of infections that could lead to septic arthritis.

RESOURCES:

Arthritis Foundation
http://www.arthritis.org
National Institute of Arthritis and Musculoskeletal and Skin Diseases
http://www.niams.nih.gov

CANADIAN RESOURCES:

The Arthritis Society
http://www.arthritis.ca

References:

Ernst AA, Weiss SJ, Tracy LA, Weiss NR. Usefulness of CRP and ESR in predicting septic joints. South Med J. 2010;103(6):522-526.
Howard A, Wilson M. Septic arthritis in children. BMJ. 2010;341:c4407.
Ma L, Cranney A, Holroyd-Leduc JM. Acute monoarthritis: what is the cause of my patient's painful swollen joint? CMAJ. 2009;180(1):59-65.
Septic arthritis in adults. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T116123/Septic-arthritis. Updated May 30, 2017. Accessed January 11, 2018.
Septic arthritis in children. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T116123/Septic-arthritis. Updated December 5, 2017. Accessed January 11, 2018.
Septic arthritis. Patient UK website. Available at
...(Click grey area to select URL)
Updated August 30, 2013. Accessed June 29, 2015.
Last reviewed January 2018 by Michael Woods, MD
Last Updated: 1/11/2018

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