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==X Ray==
==X Ray==
Traditionally, the diagnosis of septic arthritis was based on clinical assessment and prompt [[arthrocentesis]]. However, the clinical picture may be obscured by multiple confounding factors and a paucity of specific findings especially for the deep joints, i.e. the [[hip]] or [[shoulder]].  Imaging can be used to confirm the diagnosis of septic arthritis and more importantly, imaging findings suggestive of septic arthritis can direct the clinician to a diagnosis that may not have been considered.
X-ray of the joint with septic arthritis are usually normal in the first few days of infection as there is no joint destruction usually or may show a preexisting joint disease such as rheumatoid arthritis or osteoarthritis. So, the initial x-ray may be useful to determine pre-existing conditions, such as osteoarthritis or simultaneous osteomyelitis, or may be useful as a baseline image in monitoring the treatment response. However, in the late stages of septic arthritis, X-ray film may show: swelling of the joint capsule and soft tissue around the joint, fat pad displacement, and joint space widening due to localized edema and effusion.<ref name="pmid7618566">Jaramillo D, Treves ST, Kasser JR, Harper M, Sundel R, Laor T (1995) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=7618566 Osteomyelitis and septic arthritis in children: appropriate use of imaging to guide treatment.] ''AJR Am J Roentgenol'' 165 (2):399-403. [http://dx.doi.org/10.2214/ajr.165.2.7618566 DOI:10.2214/ajr.165.2.7618566] PMID: [https://pubmed.gov/7618566 7618566]</ref><ref name="pmid12364368">Shirtliff ME, Mader JT (2002) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=12364368 Acute septic arthritis.] ''Clin Microbiol Rev'' 15 (4):527-44. PMID: [https://pubmed.gov/12364368 12364368]</ref><ref name="pmid21916390">Horowitz DL, Katzap E, Horowitz S, Barilla-LaBarca ML (2011) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=21916390 Approach to septic arthritis.] ''Am Fam Physician'' 84 (6):653-60. PMID: [https://pubmed.gov/21916390 21916390]</ref>
 
Plain film findings of septic arthritis include: joint effusion, soft tissue swelling, periarticular [[osteoporosis]], loss of joint space, marginal and central [[erosion]]s and bone [[ankylosis]].


==References==
==References==

Revision as of 19:42, 20 January 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Jumana Nagarwala, M.D., Senior Staff Physician, Department of Emergency Medicine, Henry Ford Hospital; Cafer Zorkun, M.D., Ph.D. [2]Venkata Sivakrishna Kumar Pulivarthi M.B.B.S [3]

Overview

To establish the diagnosis of septic arthritis, specific imaging studies such as plane radiograph, ultrasound, CT scan, MRI or bone scan may not be useful, but imaging studies are useful differentiate septic arthritis from other forms of acute arthritis and also useful to to support a clinical suspicion of the disease and to assess the extent of inflammation, joint destruction and the past rheumatological disorders if present.

X Ray

X-ray of the joint with septic arthritis are usually normal in the first few days of infection as there is no joint destruction usually or may show a preexisting joint disease such as rheumatoid arthritis or osteoarthritis. So, the initial x-ray may be useful to determine pre-existing conditions, such as osteoarthritis or simultaneous osteomyelitis, or may be useful as a baseline image in monitoring the treatment response. However, in the late stages of septic arthritis, X-ray film may show: swelling of the joint capsule and soft tissue around the joint, fat pad displacement, and joint space widening due to localized edema and effusion.[1][2][3]

References

  1. Jaramillo D, Treves ST, Kasser JR, Harper M, Sundel R, Laor T (1995) Osteomyelitis and septic arthritis in children: appropriate use of imaging to guide treatment. AJR Am J Roentgenol 165 (2):399-403. DOI:10.2214/ajr.165.2.7618566 PMID: 7618566
  2. Shirtliff ME, Mader JT (2002) Acute septic arthritis. Clin Microbiol Rev 15 (4):527-44. PMID: 12364368
  3. Horowitz DL, Katzap E, Horowitz S, Barilla-LaBarca ML (2011) Approach to septic arthritis. Am Fam Physician 84 (6):653-60. PMID: 21916390


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