Last reviewed: June 2019
Last updated: January  2019

Summary

Definition

History and exam

Key diagnostic factors

  • hot, swollen, tender, restricted joint

Other diagnostic factors

  • low socioeconomic status
  • history of intravenous drug abuse
  • history of diabetes
  • history of cutaneous ulcers
  • prosthetic joint
  • history of rheumatoid arthritis or osteoarthritis
  • short history of symptoms
  • fever
  • history of alcohol use disorder
  • history of previous corticosteroid injection

Risk factors

  • underlying joint disease
  • joint prostheses
  • intravenous drug abuse
  • diabetes
  • presence of cutaneous ulcers
  • alcohol use disorder
  • previous intra-articular corticosteroid injection

Diagnostic investigations

1st investigations to order

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

Treatment algorithm

Contributors

Authors VIEW ALL

Gerald Coakley

Consultant Rheumatologist

Queen Elizabeth Hospital

London

UK

Disclosures

GC is an author of a reference cited in this topic.

Catherine J. Mathews

Consultant Rheumatologist

Queen Elizabeth Hospital

London

UK

Disclosures

CJM is an author of a reference cited in this topic.

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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