Close
New

Medscape is available in 5 Language Editions – Choose your Edition here.

 

Nongonococcal Infectious Arthritis Clinical Presentation

  • Author: Edward Dwyer, MD; Chief Editor: Herbert S Diamond, MD  more...
 
Updated: Mar 15, 2016
 

History

The clinical course of bacterial arthritis is typically acute in onset. Patients with joint prostheses are the exception to this general rule: Their symptoms may persist for weeks or months before a diagnosis is made. Individuals with mycobacterial or fungal arthritis also tend to have a much more indolent or subacute prodrome before the diagnosis is considered.

Joint pain, swelling, erythema, and loss of motion are common presenting symptoms. The most commonly affected joint in persons with bacterial arthritis is the knee. The shoulder, hip, elbow, and wrist joints are infected less frequently. The sternoclavicular and sacroiliac joints are preferentially involved in patients who use illicit parenteral drugs.

Approximately 10% of individuals with bacterial arthritis have infection in multiple joints, particularly in the presence of a preexisting destructive joint disease (eg, rheumatoid arthritis) or compromising medical conditions (eg, diabetes and conditions necessitating glucocorticoid therapy).[8]

Next

Physical Examination

During the first 24 hours of hospitalization, 78% of patients with nongonococcal bacterial arthritis exhibit fever; however, the fever rarely exceeds 39°C (102.2°F).[1]

The patient may have decreased range of motion in the joint. Swelling, tenderness to palpation, erythema, warmth to touch, and pain upon movement of the affected joint are common physical examination findings.

Previous
 
 
Contributor Information and Disclosures
Author

Edward Dwyer, MD Associate Professor of Medicine, Columbia University Medical Center

Edward Dwyer, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Rheumatology

Disclosure: Nothing to disclose.

Chief Editor

Herbert S Diamond, MD Visiting Professor of Medicine, Division of Rheumatology, State University of New York Downstate Medical Center; Chairman Emeritus, Department of Internal Medicine, Western Pennsylvania Hospital

Herbert S Diamond, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American College of Rheumatology, American Medical Association, Phi Beta Kappa

Disclosure: Nothing to disclose.

Acknowledgements

Elliot Goldberg, MD Dean of the Western Pennsylvania Clinical Campus, Professor, Department of Medicine, Temple University School of Medicine

Elliot Goldberg, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, and American College of Rheumatology

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Robert E Wolf, MD, PhD Professor Emeritus, Department of Medicine, Louisiana State University School of Medicine in Shreveport; Chief, Rheumatology Section, Medical Service, Overton Brooks Veterans Affairs Medical Center

Robert E Wolf, MD, PhD is a member of the following medical societies: American College of Rheumatology, Arthritis Foundation, and Society for Leukocyte Biology

Disclosure: Nothing to disclose.

References
  1. Smith JW, Chalupa P, Shabaz Hasan M. Infectious arthritis: clinical features, laboratory findings and treatment. Clin Microbiol Infect. 2006 Apr. 12(4):309-14. [Medline].

  2. García-De La Torre I, Nava-Zavala A. Gonococcal and nongonococcal arthritis. Rheum Dis Clin North Am. 2009 Feb. 35(1):63-73. [Medline].

  3. Shirtliff ME, Mader JT. Acute septic arthritis. Clin Microbiol Rev. 2002 Oct. 15(4):527-44. [Medline].

  4. Bosilkovski M, Zezoski M, Siskova D, Miskova S, Kotevska V, Labacevski N. Clinical characteristics of human brucellosis in patients with various monoarticular involvements. Clin Rheumatol. 2016 Feb 9. [Medline].

  5. Dubost JJ, Couderc M, Tatar Z, Tournadre A, Lopez J, Mathieu S, et al. Three-decade trends in the distribution of organisms causing septic arthritis in native joints: Single-center study of 374 cases. Joint Bone Spine. 2014 Oct. 81(5):438-40. [Medline].

  6. Gupta MN, Sturrock RD, Field M. A prospective 2-year study of 75 patients with adult-onset septic arthritis. Rheumatology (Oxford). 2001 Jan. 40(1):24-30. [Medline].

  7. Kaandorp CJ, Krijnen P, Moens HJ, Habbema JD, van Schaardenburg D. The outcome of bacterial arthritis: a prospective community-based study. Arthritis Rheum. 1997 May. 40(5):884-92. [Medline].

  8. Goldenberg DL, Reed JI. Bacterial arthritis. N Engl J Med. 1985 Mar 21. 312(12):764-71. [Medline].

  9. von Essen R. Culture of joint specimens in bacterial arthritis. Impact of blood culture bottle utilization. Scand J Rheumatol. 1997. 26(4):293-300. [Medline].

  10. Chambers HF. Community-associated MRSA--resistance and virulence converge. N Engl J Med. 2005 Apr 7. 352(14):1485-7. [Medline].

  11. Harrington JT. Mycobacterial and fungal arthritis. Curr Opin Rheumatol. 1998 Jul. 10(4):335-8. [Medline].

 
Previous
Next
 
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.