Septic Arthritis

Septic, or infectious, arthritis is a very painful process that can lead to significant joint destruction if it isn’t managed quickly and effectively.   It occurs when a joint that hasn’t been replaced becomes infected by some type of bacterial or fungal organism. The organism causing the infection might reach the joint through the bloodstream, as a result of another infection in the body (such as a urinary tract infection or bladder infection), or it may be the result of an injury where something pierced into the joint from the outside (such as a bite or puncture into the joint).  

The joint responds to the bacteria by becoming inflamed. This inflammation, if left untreated, can lead to breakdown of the joint lining much like what occurs in arthritis due to degenerative joint disease.

Some people may be more susceptible to developing septic arthritis. Having an autoimmune disorder like rheumatoid arthritis can place someone at a higher risk because they are less able to fight off an infection especially if they are taking medications to treat their autoimmune disorder.  

Symptoms of Septic Arthritis

In addition to being extremely painful, septic arthritis can cause a joint to become inflamed and swollen. Because of the pain and swelling, range of motion is usually decreased and a person with a septic joint will be less inclined to use that extremity.

Diagnosing Septic Arthritis

Diagnosing septic arthritis involves removing fluid from the affected joint (needle aspiration) and having the fluid analyzed. By analyzing the fluid, the treating physician will know the infective organism  and be able to prescribe the most effective antibiotic to use to treat the infection.  

An x-ray is often done to determine the extent of joint damage in order to help make recommendations for further treatment.

Treatment of Septic Arthritis

Removing the infected joint fluid is necessary to effectively manage septic arthritis. This may be done as an arthroscopic surgical procedure where small incisions are made into the joint. A tube with a small camera is then inserted into the joint through one of the incisions, and other tubes are inserted to drain the joint and flush the joint fluid out.  The camera allows the surgeon to look closely at the joint and examine the extent of damage.  In situations where an arthroscopic procedure won’t be effective, an open irrigation and drainage will be necessary.

After the surgical procedure a patient will be placed on a course of antibiotics to treat any infective organism that remains. 

With early intervention, most people don’t have any functional loss from septic arthritis. If joint damage has occurred, further reconstructive surgery may be necessary due to the extent of the damage.