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Medical Author:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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Medical Editor:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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In this Article

• What is septic arthritis?
• What microbes cause septic arthritis?
• Who is at risk of developing septic arthritis?
• What are symptoms and signs of septic arthritis?
• How is septic arthritis diagnosed?
• How is septic arthritis treated?
• What are complications of septic arthritis?
• Septic Arthritis At A Glance
• Septic Arthritis Index

Septic arthritis is treated with antibiotics and drainage of the infected joint (synovial) fluid from the joint.

Optimally, antibiotics are given immediately. Often, intravenous antibiotics are administered in a hospital setting. The choice of antibiotics can be guided by the results of the culture of joint fluid. Until those results are known, empiric antibiotics are chosen to cover a wider range of possible infectious agents. Sometimes, combinations of antibiotics are given. Antibiotics can be required for four to six weeks.

Drainage is essential for rapid clearing of the infection. Drainage can be done by regular aspirations with a needle and syringe, often daily early on, or via surgical procedures. Arthroscopy can be used to irrigate the joint and remove infected joint lining tissue. If adequate drainage cannot be accomplished with joint aspirations or arthroscopy, open joint surgery is used to drain the joint. After arthroscopy or open joint surgery, drains are sometimes left in place to drain excess fluid that can accumulate after the procedure.

Rapid clearing of the infection is critical to preserve the joint. If appropriate antibiotics are begun immediately, joint integrity can be maintained, and return to function is expected. If the infection has been long-standing, the possibility of joint destruction exists. The keys to successful outcome are rapid medical attention and drainage and the accurate administration of antibiotics to which the offending microbes are susceptible.

• Septic arthritis is infection of one or more joints by microorganisms.
• Septic arthritis can be caused by bacteria, viruses, and fungi.
• Risks for the development of septic arthritis include taking immune-suppression medicines, intravenous drug abuse, past joint disease, injury or surgery, and underlying medical illnesses including diabetes, alcoholism, sickle cell disease, rheumatic diseases, and immune deficiency disorders.
• Symptoms of septic arthritis include fever, chills, as well as joint pain, swelling, redness, stiffness, and warmth.
• Septic arthritis is diagnosed by identifying infected joint fluid.
• Septic arthritis is treated with antibiotics and drainage of the infected joint fluid from the joint.