Septic Arthritis


Sign Normal GROUP 1 :
NON-Inflammatory
(Osteoarthritis, Hypothyroidism)
GROUP 2:
Inflammatory
(RA, Gout, CPPD, Spondylarthopathy)
GROUP 3:
Septic
Clarity Transparent Transparent Slightly opaque Opaque
Color Clear Yellow Yellow-opalescent Yellow-green
Viscosity High High Low Usually low
Culture (-) (-) (-) Often (+)
WBCs < 200 200-2000 2000-50,000 > 50,000
PMNs (%) < 25 < 25 > 50 > 75

Diagnosis

Pathophysiology

Differential Diagnoses

  1. Rheumatoid arthritis, osteoarthritis, gout, pseudogout
  2. Osteomyelitis, trauma, lyme dz, cellulitis, tumors, SLE
  3. Children

Treatment

  1. Depends on location & cause
  2. Treat sepsis as appropriate
  3. Orthopedic consult for joint aspiration/tx
  4. Medication

Disposition

  1. Admit all pts: degree of care depends upon underlying condition
  2. Treatment: at least 2 wks after fever/joint effusion resolution
  3. Watch for continued symptoms, persistently elevated ESR, poor ROM after Abx tx indicating tx failure