MusculoskeletalPending review

Septic Arthritis

A joint-destroying emergency in which bacteria seed the synovium and, unrestrained by a poor local immune barrier, trigger a bacterial-and-host enzymatic assault that can destroy cartilage within days.

In a nutshell

Bacteria seed the poorly defended synovium and, through a combination of bacterial toxins and the host's own neutrophil enzymes, destroy cartilage within days. It is an emergency: aspirate the joint before giving antibiotics, then give urgent intravenous antibiotics and consider surgical washout.

Classic presentation

A patient with a hot, red, exquisitely painful, immobile single joint of rapid onset, fever, and a risk factor such as a prosthetic joint, diabetes or intravenous drug use.

Key points

The synovium has no basement membrane, so bacteraemia readily seeds the joint, and enclosed cartilage offers poor access for host defence or antibiotics.

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Educational content pending clinical review. Not medical advice.