Last reviewed: 14 Feb 2025
Last updated: 17 Jan 2019
Summary
Definition
History and exam
Key diagnostic factors
- 发热、肿胀、压痛和关节活动受限
Full details
Other diagnostic factors
- 低等社会经济状况
- 静脉注射毒品既往史
- 糖尿病史
- 皮肤溃疡病史
- 假体关节
- 类风湿性关节炎或骨关节炎病史
- 症状的病史短
- 发热
- 酒精使用障碍既往史
- 皮质类固醇注射既往史
Full details
Risk factors
- 潜在关节病
- 关节假体
- 静脉注射药物滥用
- 糖尿病
- 存在皮肤溃疡
- 酒精使用障碍
- 先前关节内皮质类固醇注射
Full details
Diagnostic tests
1st tests to order
- 关节液革兰染色和培养
- 滑液白细胞计数
- 血液培养
- 白细胞计数
- 红细胞沉降率
- C 反应蛋白 (CRP)
- X 线平片影像学检查
- 超声
Full details
Tests to consider
- 核磁共振成像 (MRI)
Full details
Treatment algorithm
INITIAL
疑似革兰阳性菌感染或革兰染色阴性
疑似革兰阴性菌感染
ACUTE
确诊 MSSA 或链球菌感染
确诊 MRSA 感染
确诊革兰阴性杆菌感染
确诊淋球菌或脑膜炎双球菌感染
真菌/结核病/其他微生物感染
Contributors
Authors
Gerald Coakley, PhD, FRCP
Consultant Rheumatologist
Queen Elizabeth Hospital
London
UK
Disclosures
GC is an author of a reference cited in this topic.
Catherine J. Mathews, MSc, FRCP
Consultant Rheumatologist
Queen Elizabeth Hospital
London
UK
Disclosures
CJM is an author of a reference cited in this topic.
Peer reviewers
Andrew Keat, MBBS
Consultant Physician and Rheumatologist
Northwick Park Hospital
Harrow
UK
Disclosures
AK declares that he has no competing interests.
Cheryl Main, MD, FRCPC
Medical Microbiologist
Infectious Disease Consultant
Hamilton Regional Laboratory Medicine Program
Hamilton Health Sciences
Hamilton
Canada
Disclosures
CM declares that she has no competing interests.
John Ross, MD
Brigham and Women’s Hospital
Hospitalist Section
Boston
MA
Disclosures
JR declares that he has no competing interests.
Differentials
- 骨关节炎
- 银屑病性关节炎
- 类风湿关节炎
More DifferentialsGuidelines
- ACR 适用标准：疑似骨髓炎、化脓性关节炎或软组织感染（脊柱和糖尿病足除外）
- 可用于成人红肿关节治疗的指南：BSR 和 BHPR、BOA、RCGP 以及 BSAC 指南
More GuidelinesVideos
膝关节穿刺抽吸和注射的动画演示
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