Septic arthritis physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Venkata Sivakrishna Kumar Pulivarthi M.B.B.S [2]

Overview

Patients with septic arthritis usually appear toxic.Common physical examination findings of septic arthritis include erythema, warmth, swelling, tenderness and decreased range of motion over the affected joint, usually knee.

Physical Examination

Appearance of the Patient

Vital Signs

Skin

  • Warmth over the joint

Extremities

Most commonly involves knee > hip > shoulder > ankle.[2] Other joints such as sacroiliac joint (~10%), sternoclavicular or costoclavicular joints may be involved in patient with history of intravenous drug abuse (IVDA), penetrating trauma, animal or human bites and local steroid injections.

  • Swelling of the joint that involved
  • Decreased range of motion such as pseudo paralysis
  • Patient hold the hip in flexed and externally rotated position if SA involving hip.
  • If child, unwillingness to bear weight on the affected joint (antalgic gait)

References

  1. Goldenberg DL (1998) Septic arthritis. Lancet 351 (9097):197-202. DOI:10.1016/S0140-6736(97)09522-6 PMID: 9449882
  2. Barton LL, Dunkle LM, Habib FH (1987) Septic arthritis in childhood. A 13-year review. Am J Dis Child 141 (8):898-900. PMID: 3498362

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