Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • hot, swollen, tender, restricted joint

Other diagnostic factors

  • low socioeconomic status
  • hx of IV drug abuse
  • hx of diabetes
  • hx of cutaneous ulcers
  • prosthetic joint
  • hx of rheumatoid arthritis or osteoarthritis
  • short hx of symptoms
  • fever
  • hx of alcoholism
  • hx of previous corticosteroid injection

Risk factors

  • underlying joint disease
  • joint prostheses
  • IV drug abuse
  • alcoholism
  • diabetes
  • previous intra-articular corticosteroid injection
  • presence of cutaneous ulcers

Diagnostic investigations

1st investigations to order

  • synovial fluid Gram stain and culture
  • synovial fluid white cell count
  • blood culture
  • white cell count
  • ESR
  • CRP
  • plain radiograph
  • ultrasound
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Gerald Coakley

Consultant Rheumatologist

Queen Elizabeth Hospital

London

UK

Disclosures

GC is a co-author of a reference cited in this monograph.

Catherine J. Mathews

Consultant Rheumatologist

Queen Elizabeth Hospital

London

UK

Disclosures

CJM is a co-author of a reference cited in this monograph.

Peer reviewers VIEW ALL

Consultant Physician and Rheumatologist

Northwick Park Hospital

Harrow

UK

Disclosures

AK declares that he has no competing interests.

Medical Microbiologist

Infectious Disease Consultant

Hamilton Regional Laboratory Medicine Program

Hamilton Health Sciences

Hamilton

Canada

Disclosures

CM declares that she has no competing interests.

Brigham and Women’s Hospital

Hospitalist Section

Boston

MA

Disclosures

JR declares that he has no competing interests.

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