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]Venkata Sivakrishna Kumar Pulivarthi M.B.B.S [3]
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.
Microorganism Involved Based on The Clinical History and Symptoms
| Clinical history | Joints involved | Most likely microorganism |
|---|---|---|
| Intravenous drug use[1][2] | 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[1] | 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[1] | 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)[3] |
Monoarticular: knee, ankle, or elbow | Blastomyces dermatitidis |
| Southwestern United States, Central and South America
(primary respiratory illness) |
Knee | Coccidioides immitis |
| Cleaning fish tank[1][4] | Small joints involvement (e.g. fingers, wrists) | Mycobacterium marinum |
References
- ↑ 1.0 1.1 1.2 1.3 Margaretten ME, Kohlwes J, Moore D, Bent S (2007) Does this adult patient have septic arthritis? JAMA 297 (13):1478-88. DOI:10.1001/jama.297.13.1478 PMID: 17405973
- ↑ Deesomchok U, Tumrasvin T (1990) Clinical study of culture-proven cases of non-gonococcal arthritis. J Med Assoc Thai 73 (11):615-23. PMID: 2283490
- ↑ Horowitz DL, Katzap E, Horowitz S, Barilla-LaBarca ML (2011). "Approach to septic arthritis". Am Fam Physician. 84 (6): 653–60. PMID 21916390.
- ↑ Gardam M, Lim S (2005). "Mycobacterial osteomyelitis and arthritis". Infect Dis Clin North Am. 19 (4): 819–30. doi:10.1016/j.idc.2005.07.008. PMID 16297734.