Septic Arthritis

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KEY POINTS

• Septic arthritis is a serious infection of the joints. If you have symptoms of septic arthritis, see your healthcare provider right away.
• The infection is treated with antibiotics for 3 to 6 weeks. You will likely stay in the hospital for some of this time.
• Take antibiotics for as long as your healthcare provider prescribes, even if you feel better. If you stop taking the medicine too soon, you may not kill all of the bacteria and you may get sick again.

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What is septic arthritis?

Septic arthritis is a serious infection of the joints. It needs to be diagnosed and treated quickly because it can quickly destroy bone and other tissue in your joints.

What is the cause?

Septic arthritis is usually caused by bacteria that have spread from an infection in another part of your body. The bacteria spread to your joints through your blood. A joint may also be infected from an injury or use of a dirty needle while injecting drugs, or during surgery.

Anyone can get septic arthritis, but it’s more common in older adults and young children. You are more likely to get septic arthritis if you have:

• Rheumatoid arthritis
• Joint replacement or other joint surgery
• Bacteria or other germs in your blood
• A skin infection
• A medical problem that lowers your ability to fight infections, such as diabetes or cancer
• Alcohol or IV drug abuse
• Gonorrhea, a sexually transmitted infection that can spread to the joints

What are the symptoms?

Symptoms may include:

• Swelling, redness, and pain in one or more joints, most often the knees, hips, or shoulder
• Fever and chills

If you have symptoms of septic arthritis, see your healthcare provider right away. If you do not get treatment right away, your joints may be permanently damaged.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. Tests may include:

• Blood tests
• Joint aspiration, which uses a needle to take fluid from a joint for testing
• X-rays
• Bone scan, which uses a radioactive chemical to look at your bones
• MRI, which uses a strong magnetic field and radio waves to show detailed pictures of the joints

How is it treated?

The infection is treated with antibiotics. You may need antibiotics for 3 to 6 weeks. You will likely stay in the hospital for some of this time.

Fluid may need to be drained from the infected joint. This is usually done when the joint fluid is sampled for diagnosis. In some cases, you may need to have a procedure called joint arthroscopy to drain the fluid. Arthroscopy uses a small scope inserted into your joint so your provider can look directly at your joint without having to cut open the joint. For severe septic arthritis, you may need to have surgery to open the joint to drain it and clean it out with sterile liquids.

At first, you may need to keep your infected joint in an immobilizer so that it doesn’t move. You may be able to gently move your joint again after a few days of treatment.

You will be able to leave the hospital when you no longer need IV medicine and you are able to get around at home while your joint heals. Depending on which joint is infected, you may need a wheelchair or crutches and physical therapy while you recover.

When septic arthritis is treated early, the joint usually heals completely.

How can I help take care of myself?

Follow the full course of treatment prescribed by your healthcare provider. In addition:

• Take antibiotics for as long as your healthcare provider prescribes, even if you feel better. If you stop taking the medicine too soon, you may not kill all of the bacteria and you may get sick again. If you have side effects from your medicine, talk to your healthcare provider.
• Take pain medicine as directed by your provider.
• Gentle exercise may help you keep or improve your flexibility and relieve stiffness. Ask your healthcare provider or physical therapist for the best exercises for you.
• Ask your healthcare provider:
  • How and when you will get your test results
  • How long it will take to recover
  • If there are activities you should avoid and when you can return to normal activities
  • What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

How can I help prevent septic arthritis?

If you get a cut, wash it with soap and water right away, and watch for signs of infection, especially if the injury is near a joint.

If you are at risk for septic arthritis, you may need to take antibiotics before having dental work or certain medical procedures. Ask your healthcare provider about this.

Take care of your health. Try to get at least 7 to 9 hours of sleep each night. Eat a healthy diet and try to keep a healthy weight. If you smoke, try to quit. If you want to drink alcohol, ask your healthcare provider how much is safe for you to drink. Learn ways to manage stress. Exercise according to your healthcare provider's instructions.

Practice safe sex:

• Use latex or polyurethane condoms during foreplay and every time you have vaginal, oral, or anal sex.
• Have just 1 sexual partner who is not having sex with anyone else.