eMedicine Specialties > Radiology > Musculoskeletal

Septic Arthritis: Multimedia

Author: Larry Holder, MD, Residency Director, Department of Radiology, Virginia Mason Medical Center
Coauthor(s): Matthew Studley, MD, MPH, Consulting Staff, Department of Radiology, Virginia Mason Medical Center
Contributor Information and Disclosures

Updated: Mar 22, 2007

Multimedia

A 30-year-old man who was taking steroids present...
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Media file 1: A 30-year-old man who was taking steroids presented with a joint effusion and knee pain. Anteroposterior view of the knee demonstrates patchy demineralization of the tibia and femur and joint-space narrowing. This was caused by tuberculoid infection of the joint.
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A 30-year-old man who was taking steroids present...

A 30-year-old man who was taking steroids presented with a joint effusion and knee pain. Anteroposterior view of the knee demonstrates patchy demineralization of the tibia and femur and joint-space narrowing. This was caused by tuberculoid infection of the joint.

Coronal short-tau inversion recovery MRI of the p...
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Media file 2: Coronal short-tau inversion recovery MRI of the pubic symphysis demonstrates a hyperintense joint effusion and increased signal intensity in the bone marrow of the pubic rami. Abnormal high signal intensity is also present in the bilateral hip adductor muscles. The diagnosis was septic arthritis with associated osteomyelitis and inflammatory changes in the soft tissues.
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Coronal short-tau inversion recovery MRI of the p...

Coronal short-tau inversion recovery MRI of the pubic symphysis demonstrates a hyperintense joint effusion and increased signal intensity in the bone marrow of the pubic rami. Abnormal high signal intensity is also present in the bilateral hip adductor muscles. The diagnosis was septic arthritis with associated osteomyelitis and inflammatory changes in the soft tissues.

Septic arthritis. Anteroposterior view of the sho...
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Media file 3: Septic arthritis. Anteroposterior view of the shoulder demonstrates subchondral erosions and sclerosis in the humeral head. These are relatively late findings of septic arthritis. Periosteal reaction due to coincident osteomyelitis is present adjacent to the surgical neck of the humerus.
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Septic arthritis. Anteroposterior view of the sho...

Septic arthritis. Anteroposterior view of the shoulder demonstrates subchondral erosions and sclerosis in the humeral head. These are relatively late findings of septic arthritis. Periosteal reaction due to coincident osteomyelitis is present adjacent to the surgical neck of the humerus.

Coronal T2-weighted fat-saturated MRI of the shou...
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Media file 4: Coronal T2-weighted fat-saturated MRI of the shoulder demonstrates a joint effusion, bone marrow edema, and marked adjacent soft tissue inflammation with a fluid collection in the infraspinatus muscle. This is an example of septic arthritis with associated soft tissue abscess.
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Coronal T2-weighted fat-saturated MRI of the shou...

Coronal T2-weighted fat-saturated MRI of the shoulder demonstrates a joint effusion, bone marrow edema, and marked adjacent soft tissue inflammation with a fluid collection in the infraspinatus muscle. This is an example of septic arthritis with associated soft tissue abscess.

Images 5-7 show the progression of infectious art...
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Media file 5: Images 5-7 show the progression of infectious arthritis of the hip. Image 5 was obtained early in the disease and shows only concentric joint-space loss.
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Images 5-7 show the progression of infectious art...

Images 5-7 show the progression of infectious arthritis of the hip. Image 5 was obtained early in the disease and shows only concentric joint-space loss.

Four months after Image 5 was acquired, subchondr...
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Media file 6: Four months after Image 5 was acquired, subchondral erosions and sclerosis of the femoral head are present.
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Four months after Image 5 was acquired, subchondr...

Four months after Image 5 was acquired, subchondral erosions and sclerosis of the femoral head are present.

Eight months after the initial examination, osteo...
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Media file 7: Eight months after the initial examination, osteonecrosis and complete collapse of the femoral head are present.
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Eight months after the initial examination, osteo...

Eight months after the initial examination, osteonecrosis and complete collapse of the femoral head are present.

More on Septic Arthritis

Overview: Septic Arthritis
Imaging: Septic Arthritis
Follow-up: Septic Arthritis
Multimedia: Septic Arthritis
References
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References

  1. Alazraki NP. Radionuclide imaging in the evaluation of infections and inflammatory disease. Radiol Clin North Am. Jul 1993;31(4):783-94. [Medline].

  2. Beltran J, Noto AM, McGhee RB. Infections of the musculoskeletal system: high-field-strength MR imaging. Radiology. Aug 1987;164(2):449-54. [Medline].

  3. Bennett OM, Namnyak SS. Acute septic arthritis of the hip joint in infancy and childhood. Clin Orthop. Aug 1992;(281):123-32. [Medline].

  4. Greenspan A, Tehranzadeh J. Imaging of infectious arthritis. Radiol Clin North Am. Mar 2001;39(2):267-76. [Medline].

  5. Hong S, Kim S, Ahn J. Tuberculous Versus Pyogenic Arthritis:MR Imaging Evaluation. Radiology. 2001;218:848-853. [Full Text].

  6. Jacobson AF, Harley JD, Lipsky BA, Pecoraro RE. Diagnosis of osteomyelitis in the presence of soft-tissue infection and radiologic evidence of osseous abnormalities: value of leukocyte scintigraphy. AJR Am J Roentgenol. Oct 1991;157(4):807-12. [Medline].

  7. Jaramillo D, Treves ST, Kasser JR, et al. Osteomyelitis and septic arthritis in children: appropriate use of imaging to guide treatment. AJR Am J Roentgenol. Aug 1995;165(2):399-403. [Medline].

  8. Karchevsky M, Schweitzer M, Morrison W. MRI FINDINGS OF SEPTIC ARTHRITIS AND ASSOCIATED OSTEOMYLEITIS IN ADULTS. AMERICAN JOURNAL OF ROENTGENOLOGY. 2004;182:119-122. [Full Text].

  9. Kirks DR. Practical Pediatric Imaging. 2nd ed. Lippincott-Raven;1998: 378-80.

  10. Lee SK, Suh KJ, Kim YW, et al. Septic arthritis versus transient synovitis at MR imaging: preliminary assessment with signal intensity alterations in bone marrow. Radiology. May 1999;211(2):459-65. [Medline].

  11. Miller TT, Randolph DA Jr, Staron RB, et al. Fat-suppressed MRI of musculoskeletal infection: fast T2-weighted techniques versus gadolinium-enhanced T1-weighted images. Skeletal Radiol. Nov 1997;26(11):654-8. [Medline].

  12. Morgan DS, Fisher D, Merianos A, Currie BJ. An 18 year clinical review of septic arthritis from tropical Australia. Epidemiol Infect. Dec 1996;117(3):423-8. [Medline].

  13. Resnik CS, Ammann AM, Walsh JW. Chronic septic arthritis of the adult hip: computed tomographic features. Skeletal Radiol. 1987;16(7):513-6. [Medline].

  14. Resnik D, Niwayaama G. Osteomyelitis, septic arthritis, and soft tissue infection. In: Diagnosis of Bone and Joint Disorders. Vol 4. Philadelphia: WB Saunders Co;1988: 2571-86.

  15. Schattner A, Vosti KL. Bacterial arthritis due to beta-hemolytic streptococci of serogroups A, B, C, F, and G. Analysis of 23 cases and a review of the literature. Medicine (Baltimore). Mar 1998;77(2):122-39. [Medline].

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Further Reading

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Keywords

infectious arthritis, pyogenic arthritis, pyogenic joint infections, nonpyogenic arthritis, non-pyogenic arthritis, nonpyogenic joint infections, granulomatous joint infections, bacterial arthritis, tuberculous arthritis

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Contributor Information and Disclosures

Author

Larry Holder, MD, Residency Director, Department of Radiology, Virginia Mason Medical Center
Disclosure: Nothing to disclose.

Coauthor(s)

Matthew Studley, MD, MPH, Consulting Staff, Department of Radiology, Virginia Mason Medical Center
Matthew Studley, MD, MPH is a member of the following medical societies: American College of Radiology
Disclosure: Nothing to disclose.

Medical Editor

Giuseppe Guglielmi, MD, Associate Professor of Radiology, Department of Radiology, Scientific Institute Hospital
Disclosure: Nothing to disclose.

Pharmacy Editor

Bernard D Coombs, MB, ChB, PhD, Consulting Staff, Department of Specialist Rehabilitation Services, Hutt Valley District Health Board, New Zealand
Disclosure: Nothing to disclose.

Managing Editor

William R Reinus, MD, MBA, FACR, Professor of Radiology, Temple University; Chief of Musculoskeletal and Trauma Radiology, Vice Chair, Department of Radiology, Temple University Hospital
William R Reinus, MD, MBA, FACR is a member of the following medical societies: American College of Physician Executives, American College of Radiology, American Roentgen Ray Society, Missouri State Medical Association, and Radiological Society of North America
Disclosure: Nothing to disclose.

CME Editor

Robert M Krasny, MD, Consulting Staff, Department of Radiology, The Angeles Clinic and Research Institute
Robert M Krasny, MD is a member of the following medical societies: American Roentgen Ray Society and Radiological Society of North America
Disclosure: Nothing to disclose.

Chief Editor

Felix S Chew, MD, EdM, MBA, Professor, Department of Radiology, Section Head of Musculoskeletal Radiology, Vice Chairman for Radiology Informatics, University of Washington
Felix S Chew, MD, EdM, MBA is a member of the following medical societies: American Roentgen Ray Society, Association of University Radiologists, and Radiological Society of North America
Disclosure: Nothing to disclose.

 
 
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