Types of Arthritis: Septic Arthritis

By Lewis, Sarah, PharmD

If pain, swelling and redness suddenly develop in one of your joints, see your doctor right away. It could be an infection called septic arthritis, or infectious arthritis. Bacteria are the most common cause of septic arthritis. However, septic arthritis can also be caused by viruses, fungi and parasites. Your joints can be damaged very quickly by septic arthritis, so prompt treatment is essential.

How Will I Know If I Have Septic Arthritis?

Joints are the spaces where two or more bones meet. They are made up of cartilage, ligaments, tendons, bursas (fluid-filled sacs that help cushion the joint), and the synovial membrane (lining of the joint capsule that secretes synovial fluid to lubricate the joint). More often than not, septic arthritis occurs in just one joint space, but it can affect many joints. The most common joints for septic arthritis are your knees, hips, shoulders, elbows, wrists and fingers. You will usually develop symptoms of septic arthritis rapidly, over a couple of days or even a few hours. You can have any or all of the following symptoms:

  • Red, warm, swollen joint

  • Stiff joint that is difficult to move

  • Pain when you touch the joint or move it

  • Fever and chills

  • Feeling constantly tired and weak

If you’re concerned about an infant, you may notice fussiness, a fever, and crying when you touch the joint. In addition, the infant may not move the joint. The hip is the most common site for septic arthritis in infants. Young children and elderly people may refuse to walk or use the joint, won’t let you touch the joint, and usually have a fever.

To diagnose septic arthritis, your doctor will perform a complete medical history and physical exam. Your doctor may also perform a joint aspiration. This involves inserting a needle into the joint and pulling out joint fluid to test it for an infection.

Blood tests may include a complete blood count and blood cultures to help determine if there is an infection in your blood or somewhere else in your body. Your doctor may also take an X-ray of the affected joint.

Who Gets Septic Arthritis?

You get septic arthritis from bacteria that invade your joints. The bacteria usually travel to your joints through your bloodstream from other places in your body. They can also get into your joint during joint surgery, injection of medication into a joint, or injury. There are certain factors that increase your risk of getting septic arthritis. They include:

  • Arthritis including rheumatoid arthritis, osteoarthritis, gout, and post-traumatic arthritis

  • Blood infection called sepsis

  • Open skin wounds

  • Recent joint surgery, replacement, arthroscopy, injection or injury

  • Weakened immune system from a chronic disease or medications

  • Advanced age (80 and older) or young age (3 years and younger)

  • Alcohol orintravenous drug abuse

What Are the Different Types of Septic Arthritis?

Most of the time, septic arthritis is acute, which means that it develops quickly. Less commonly, it can be chronic, which means that it develops slowly and continues with time. The symptoms of chronic septic arthritis tend to be less intense with less pain and a low-grade fever.

What Can Be Done to Remedy Septic Arthritis?

You should see your doctor right away if you have symptoms of septic arthritis. The infection can cause permanent joint damage quickly.

Antibiotic medicines are the main treatment for septic arthritis. Your doctor may also suggest nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin). NSAIDs treat your pain and reduce swelling.

In addition to medicines, your doctor may drain the infected fluid from your joint using a needle and syringe. This relieves pressure on your joint and eases pain. It’s possible that your joint will require drainage on a daily basis for a period of time.

If drainage with a needle isn’t possible or effective, your doctor may recommend arthroscopic drainage. This procedure involves draining your joint with surgical tools inserted into small incisions. In some cases, an open surgery using a larger incision (arthrotomy) may be required to drain infected fluid from your joint.

Medical Reviewer: McDonough, Brian, MD Copyright: © Copyright 2012 Health Grades, Inc. All rights reserved. May not be reproduced or reprinted without permission from Health Grades, Inc. Use of this information is governed by the HealthGrades User Agreement.

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Arthritis accounts for 39 million doctor visits each year and more than 500,000 trips to the hospital.