Septic Arthritis - Arthritis But Not As You Know It

Welcome back Rheumatology Fans,

This is a particularly unique form of arthritis and I think a little misunderstood!

What to expect in this article:

1. What IS Septic Arthritis (FREE)

2. Primary Vs Secondary

3. What Causes Septic Arthritis

4. Clinical Reasoning In The Presence Of This Possible Emergency

5. Diagnostics and Testing

6. Management

What IS Septic Arthritis

Septic Arthritis is different from other forms of inflammatory arthritis, such as Rheumatoid or Ankylosing Spondylitis, because it's not caused by an immune system dysfunction. You could argue this makes it similar to Gout and indeed its presentation shares more commonality.

Unlike Gout is fairly uncommon affecting approximately 2-6/100,000 people in the general population.

Unlike autoimmune or maybe more accurately - autoinflammatory conditions, where the immune system mistakenly reacts to joint tissues, Septic Arthritis is triggerd by an infection infiltrating the joint space. This stimulates an acute high grade immune response aimed at combating the infection, leading to intense local inflammation.

Note that in Gout it is Uric Acid crystal deposits in the joint leading to the reaction. MORE HERE.

Normally, joint spaces maintain homeostasis thanks to the synovial tissue that envelopes it, but when an infection enters, the inflammatory reaction intensifies within the joint. This heightened inflammation not only causes localised swelling but also risks rapid joint destruction if left unaddressed. Moreover, if the infection isn't promptly treated, it can escalate into a systemic issue, potentially leading to sepsis. This makes Septic Arthritis a medical emergency…

The impact of Septic Arthritis on patients is severe. They endure excruciating pain, struggle with mobility, and face significant functional limitations. Immediate intervention is imperative not only to alleviate their suffering but also to prevent further joint damage and systemic complications.

Septic Arthritis typically affects a single joint, most commonly the knee, although it can also manifest in other large joints like the hip, elbow, or ankle. Orthopedic specialists are pivotal in diagnosing and managing Septic Arthritis, often employing a combination of antibiotics and drainage procedures to address the infection effectively. In the UK this is most commonly accessed via the Accident and Emergency Department.

Primary versus Secondary