Septic arthritis
Bacterial arthritis; Non-gonococcal bacterial arthritisSeptic arthritis is inflammation of a joint due to a bacterial or fungal infection. Septic arthritis that is due to the bacteria that cause gonorrhea, has different symptoms and is called gonococcal arthritis.
Inflammation of a joint
Joint swelling is the buildup of fluid in the soft tissue surrounding the joint or the joint itself.
Read Article Now Book Mark ArticleGonorrhea
Gonorrhea is a common sexually transmitted infection (STI).
Read Article Now Book Mark ArticleGonococcal arthritis
Gonococcal arthritis is inflammation of a joint due to a gonorrhea infection. Gonococcal arthritis is a type of septic arthritis. This is inflammati...
Read Article Now Book Mark ArticleCauses
Septic arthritis develops when bacteria or other tiny disease-causing organisms (microorganisms) spread through the blood to a joint. It may also occur when the joint is directly infected with a microorganism from an injury or during surgery. Joints that are commonly affected are the knee and hip.
Most cases of acute septic arthritis are caused by staphylococcus or streptococcus bacteria.
Acute
Acute means sudden. Acute symptoms appear, change, or worsen rapidly. It is the opposite of chronic.
Read Article Now Book Mark ArticleChronic septic arthritis (which is less common) is caused by organisms including Mycobacterium tuberculosis and Candida albicans.
The following conditions increase your risk for septic arthritis:
- Artificial joint implants
- Bacterial infection somewhere else in your body
- Presence of bacteria in your blood
- Chronic illness or disease (such as diabetes, rheumatoid arthritis, and sickle cell disease)
Chronic
Chronic refers to something that continues over an extended period of time. A chronic condition is usually long-lasting and does not easily or quick...
Read Article Now Book Mark ArticleRheumatoid arthritis
Rheumatoid arthritis (RA) is a disease that leads to inflammation of the joints and surrounding tissues. It is a long-term disease. It can also aff...
Read Article Now Book Mark ArticleSickle cell disease
Sickle cell disease is a disorder passed down through families. The red blood cells that are normally shaped like a disk take on a sickle or crescen...
Read Article Now Book Mark Article - Intravenous (IV) or injection drug use
- Medicines that suppress your immune system
- Recent joint injury
- Recent joint arthroscopy or other joint surgery
Septic arthritis may be seen at any age. In children, it occurs most often in those younger than 3 years. The hip is often the site of infection in infants. Most cases are caused by the bacteria group B streptococcus. Another common cause is Haemophilus influenza, especially if the child has not been vaccinated for this bacterium.
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.
Joint swelling
Joint swelling is the buildup of fluid in the soft tissue surrounding the joint or the joint itself.
Read Article Now Book Mark ArticleSymptoms in newborns or infants:
- Crying when infected joint is moved (for example, during diaper changes)
- Fever
- Not able to move the limb with the infected joint (pseudoparalysis)
- Fussiness
Symptoms in children and adults:
- Not able to move the limb with the infected joint (pseudoparalysis)
- Severe joint pain
- Joint swelling
- Joint redness
- Fever
Chills may occur, but are uncommon.
Exams and Tests
Your health care provider will examine the joint and ask about the symptoms.
Tests that may be done include:
- Aspiration of joint fluid for cell count, examination of crystals under the microscope, Gram stain, and culture
Aspiration of joint fluid
Synovial fluid analysis is a group of tests that examine joint (synovial) fluid. The tests help diagnose and treat joint-related problems.
Read Article Now Book Mark ArticleCulture
Joint fluid culture is a laboratory test to detect infection-causing germs in a sample of fluid surrounding a joint.
Read Article Now Book Mark Article - Blood culture
Blood culture
A blood culture is a laboratory test to check for bacteria or other germs in a blood sample.
Read Article Now Book Mark Article - X-ray of affected joint
X-ray of affected joint
This test is an x-ray of a knee, shoulder, hip, wrist, ankle, or other joint.
Read Article Now Book Mark Article - Blood work including complete blood count (CBC)
Complete blood count
A complete blood count (CBC) test measures the following:The number of white blood cells (WBC count)The number of red blood cells (RBC count)The numb...
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Treatment
Antibiotics are used to treat the infection.
Resting, raising the joint above heart level, and using cool compresses may help relieve pain. After the joint starts to heal, exercising it can help speed up recovery.
If joint (synovial) fluid builds up quickly due to the infection, a needle may be inserted into the joint to withdraw (aspirate) the fluid. Severe cases may need surgery to drain the infected joint fluid and irrigate (wash) the joint.
Aspirate
Aspiration means to draw in or out using a sucking motion. It has two meanings:Breathing in a foreign object (for example, sucking food into the air...
Read Article Now Book Mark ArticleOutlook (Prognosis)
Recovery is good with prompt antibiotic treatment. If treatment is delayed, permanent joint damage may result.
When to Contact a Medical Professional
Contact for an appointment with your provider if you develop symptoms of septic arthritis.
Prevention
Preventive (prophylactic) antibiotics may be helpful for people at high risk.
References
Cook PP, Siraj DS. Bacterial arthritis. In: Firestein GS, Budd RC, Gabriel SE, Koretzky GA, McInnes IB, O'Dell JR, eds. Firestein & Kelley's Textbook of Rheumatology. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 116.
Robinette E, Shah SS. Septic arthritis. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 705.
Review Date: 5/19/2023
Reviewed By: Jatin M. Vyas, MD, PhD, Associate Professor in Medicine, Harvard Medical School; Associate in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.