Advances in the Management of Bacterial Septic Arthritis

The clinical presentation of a patient with one or more hot, swollen joints is common. The differential diagnosis is broad but the most serious potential cause is bacterial septic arthritis. The management of bacterial septic arthritis relies on early recognition, diagnosis and timely drainage of purulent material, together with prompt administration of antibiotic therapy. If the diagnosis is not made rapidly then the treatment of septic arthritis may be delayed, which can lead to substantial morbidity due to catastrophic joint damage [1], as well as significant mortality due to overwhelming septicemia [2]. The differential diagnosis of bacterial septic arthritis includes inflammatory arthritis, crystal arthropathy, trauma, hemarthrosis and degenerative joint disease. Even in the hands of experienced physicians, the crucial diagnosis of septic arthritis can be a difficult one to confirm. Despite advances in laboratory techniques, efforts are still being made to find a synovial or serum investigation of sufficient sensitivity and specificity to clinch the diagnosis. In addition, the emergence of unusual and resistant organisms makes the management of septic arthritis an ongoing challenge.