Septic arthritis

To diagnose septic arthritis, your healthcare professional takes a medical history and does a physical exam. The exam may involve looking at all your joints for swelling, warmth, pain and a change of color.

Tests

The following tests can help diagnose septic arthritis:

• Study of joint fluid. Infections can change the color and other factors of the fluid within the joints. A healthcare professional can use a needle to take a sample of this fluid. Lab tests can show what germ is causing the infection. This helps your healthcare professional know which medicines to prescribe.
• Blood tests. These can show if there are signs of infection in your blood. The test uses a sample of your blood taken from a vein with a needle.
• Imaging tests. X-rays and other imaging tests of the affected joint can show damage to the joint or loosening of an artificial joint.

Joint drainage and antibiotic medicines treat septic arthritis.

Joint drainage

A healthcare professional may need to remove fluid from the infected joint. Ways to drain the fluid include the following:

• Needle. Sometimes, a healthcare professional can remove fluid from the infected joint with a needle put into the joint space.
• Scope procedure. In arthroscopy (ahr-THROS-kuh-pee), a tube with a video camera at its tip goes into the joint through a small cut called an incision. A healthcare professional puts tubes to drain the fluid through small cuts around the joint.
• Open surgery. Some joints, such as the hip, are harder to drain with a needle or arthroscopy. So you might need an open surgical procedure.

Antibiotics

You most often get an antibiotic through a vein in your arm at first. Later, you may be able to switch to an antibiotic in pill form. Treatment may last from 2 to 6 weeks or longer.

Side effects of antibiotics may include upset stomach, vomiting and loose stool. Allergic reactions also can happen. Ask your healthcare professional what side effects to expect from your medicine.

Removal of replacement joint

If a replacement joint is infected, treatment often involves removing the joint and replacing it for a time with a joint spacer. A joint spacer is made of bone cement and full of antibiotics. The spacer helps you use the joint during treatment. After a few months, you get a new replacement joint.

Sometimes a surgeon removes the implant, washes out the joint and places a new implant in a single surgery.

It's not always possible to remove the replacement joint. Then your healthcare professional may clean the joint and remove damaged tissue but keep the joint in place. You get antibiotics through a vein, then in a pill for several months to keep the infection from coming back.

You'll likely first see your main healthcare professional. Your healthcare professional may send you to a doctor who specializes in joint and bone surgery, called an orthopedist, an infectious disease specialist or a joint specialist, called a rheumatologist.

Here's some information to help you get ready for your appointment.

What you can do

When you call to make the appointment, ask if you need to do anything before you go, such as fasting before certain tests. Make a list of:

• Your symptoms, including any that may not seem linked to the reason for your appointment, and when they began.
• Key personal information, including other medical conditions you have and recent infections.
• All medicines, vitamins and supplements you take, including doses.
• Questions to ask your healthcare professional.

Take a family member or friend along, if possible, to help you remember information you get.

For septic arthritis, questions to ask include:

• What might be causing my symptoms?
• What are other possible causes?
• What tests do I need?
• Is my condition likely to go away or to last?
• What treatment do you suggest?
• How soon can I expect my symptoms to get better with treatment?
• What can I do in the meantime for my joint pain?
• Am I at risk of long-term complications from this condition?
• How can I best manage this condition with my other health issues?
• Are there brochures or other printed material that I can have? What websites do you suggest?

Be sure to ask all the questions you have.

What to expect from your doctor

Be ready to answer questions such as:

• How bad are your symptoms?
• Do they come and go or stay with you?
• What, if anything, seems to make your symptoms better?
• What, if anything, seems to make your symptoms worse?
• Have you ever had joint surgery or joint replacement?
• Do you use needles to take drugs?