The following tests typically help diagnose septic arthritis:
- Joint fluid analysis. Infections can alter the color, consistency, volume and makeup of the fluid within your joints. A sample of this fluid can be withdrawn from your affected joint with a needle. Laboratory tests can determine what organism is causing your infection, so your doctor will know which medications to prescribe.
- Blood tests. These can determine if there are signs of infection in your blood. A sample of your blood is removed from a vein with a needle.
Imaging tests. X-rays and other imaging tests of the affected joint can assess damage to the joint or loosening of an artificial joint.
A specialized scan that involves swallowing or injecting a small amount of a radioactive chemical may be used if your doctor suspects you have a prosthetic joint infection and it's been more than a year since you've had surgery.
Doctors rely on joint drainage and antibiotic drugs to treat septic arthritis.
Removing the infected joint fluid is crucial. Drainage methods include:
- Needle. In some cases, your doctor can withdraw the infected fluid with a needle inserted into the joint space.
- Scope procedure. In arthroscopy (ahr-THROS-kuh-pee), a flexible tube with a video camera at its tip is placed in your joint through a small incision. Suction and drainage tubes are then inserted through small incisions around your joint.
- Open surgery. Some joints, such as the hip, are more difficult to drain with a needle or arthroscopy, so an open surgical procedure might be necessary.
To select the most effective medication, your doctor must identify the microbe causing your infection. Antibiotics are usually given through a vein in your arm at first. Later, you may be able to switch to oral antibiotics.
Typically, treatment lasts from two to six weeks. Antibiotics carry a risk of side effects, including nausea, vomiting and diarrhea. Allergic reactions also can occur. Ask your doctor about what side effects to expect from your medication.
Removal of replacement joint
If an artificial joint is infected, treatment often involves removing the joint and temporarily replacing it with a joint spacer — a device made with antibiotic cement. Several months later, a new replacement joint is implanted.
If a replacement joint can't be removed, a doctor may clean the joint and remove damaged tissue but keep the artificial joint in place. Intravenous antibiotics are followed by oral antibiotics for several months to prevent the infection from coming back.
Preparing for your appointment
If you have painful and inflamed joints, you're likely to start by seeing your family doctor. He or she may refer you to an orthopedic surgeon, infectious disease specialist or joint specialist (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 in advance, such as fasting for certain tests. Make a list of:
- Your symptoms, including any that may seem unrelated to the reason for which you scheduled the appointment
- Key personal information, including other medical conditions you have and recent infections
- Medications, vitamins or supplements you take, including doses
- Questions to ask your doctor
Take a family member or friend along, if possible, to help you remember information you're given.
For septic arthritis, questions to ask your doctor include:
- What is likely causing my symptoms?
- Are there other possible causes?
- What tests do I need?
- Is my condition likely temporary or chronic?
- What's the best course of action?
- Are there alternatives to the approach you're suggesting?
- How soon can I expect my symptoms to improve with treatment?
- What can I do in the meantime to help relieve 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 problems?
- Should I see a specialist?
- Are there brochures or other printed material that I can take? What websites do you recommend?
Don't hesitate to ask other questions.
What to expect from your doctor
Your doctor is likely to ask you questions, such as:
- When did your symptoms begin?
- Have your symptoms been continuous or occasional?
- How severe are your symptoms?
- What, if anything, seems to improve your symptoms?
- What, if anything, appears to worsen your symptoms?
- Have you ever had joint surgery or joint replacement?
- Do you use recreational drugs?
Nov 24, 2022
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- Sigmund IK, et al. Diagnosis of bone and joint infections. Orthopaedics and Trauma. 2019; doi:10.1016/j.mporth.2019.03.001.
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- Goldman L, et al., eds. Infections of bursae, joints and bones. In: Goldman-Cecil Medicine. 26th ed. Elsevier; 2020. https://www.clinicalkey.com. Accessed Jan. 11, 2021.
- Berbari E, et al. Prosthetic joint infection: Epidemiology, microbiology, clinical manifestations and diagnosis. https://www.uptodate.com/contents/search. Accessed Jan. 12, 2021.
- Tosh PK (expert opinion). Mayo Clinic. Jan. 11, 2021.
- Joint replacement infection. American Academy of Orthopaedic Surgeons. https://orthoinfo.aaos.org/en/diseases--conditions/joint-replacement-infection. Accessed Jan. 25, 2021.