Septic arthritis history and symptoms
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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]
Overview
Septic arthritis should be considered whenever one is assessing a patient with joint pain. Usually only one joint is affected (monoarthritis) however in seeding arthritis, several joints can be affected simultaneously; this is especially the case when the infection is caused by staphylococcus or gonococcus bacteria.
Symptoms
Common Symptoms
Symptoms usually come on quickly. There is a fever, and joint swelling that is usually in just one joint. There is also intense joint pain, which gets worse with movement.
Symptoms in newborns or infants:
- Cries when infected joint is moved (example: diaper change causes crying if hip joint is infected)
- Fever
- Inability to move the limb with the infected joint (pseudoparalysis)
- Irritability
Symptoms in children and adults:
- Inability to move the limb with the infected joint (pseudoparalysis)
- Intense joint pain
- Joint swelling
- Joint redness
- Low fever
Less Common Symptoms
Chills may occur, but are uncommon.
| Clinical history | Joints involved | Most likely microorganism |
|---|---|---|
| Intravenous drug use | Involvement of axial joints(e.g. sternoclavicular or sacroiliac joint) | Pseudomonas aeruginosa
Staphylococcus aureus |
| Sexual activity | Tenosynovial involvement in hands, wrists, or ankles | Neisseria gonorrhoeae |
| Terminal complement deficiency | Tenosynovial involvement in hands, wrists, or ankles | Neisseria gonorrhoeae |
| Dog or cat bite | Small joints involvement | Capnocytophaga species
Pasteurella multocida |
| Ingestion of unpasteurized dairy products | Monoarticular involvement, in specific sacroiliac joint | Brucella species |
| Nail through shoe | Foot | Pseudomonas aeruginosa |
| Soil exposure/gardening | Monoarticular involvement: knee, hand, or wrist | Nocardia species
Sporothrix schenckii |
| Soil or dust exposure containing decomposed wood
(north-central and southern United States) |
Monoarticular: knee, ankle,
or elbow |
Blastomyces dermatitidis |
| Southwestern United States, Central and South
America (primary respiratory illness) |
Knee | Coccidioides immitis |
| Cleaning fish tank | Small joints involvement (e.g. fingers, wrists) | Mycobacterium marinum |