Septic arthritis x ray

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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

To establish the diagnosis of septic arthritis, specific imaging studies such as plane radiograph, ultrasound, CT scan, MRI or bone scan may not be useful, but imaging studies are useful differentiate septic arthritis from other forms of acute arthritis and also useful to to support a clinical suspicion of the disease and to assess the extent of inflammation, joint destruction and the past rheumatological disorders if present.

X Ray

X-ray of the joint with septic arthritis are usually normal in the first few days of infection as there is no joint destruction usually or may show a preexisting joint disease such as rheumatoid arthritis or osteoarthritis. So, the initial x-ray may be useful to determine pre-existing conditions, such as osteoarthritis or simultaneous osteomyelitis, or may be useful as a baseline image in monitoring the treatment response. However, in the late stages of septic arthritis, X-ray film may show: swelling of the joint capsule and soft tissue around the joint, fat pad displacement, and joint space widening due to localized edema and effusion.[1][2][3]

Septic arthritis of right hip x-ray

Case courtesy of Dr Matt Skalski, Radiopaedia.org, rID: 29079

References

  1. Jaramillo D, Treves ST, Kasser JR, Harper M, Sundel R, Laor T (1995) Osteomyelitis and septic arthritis in children: appropriate use of imaging to guide treatment. AJR Am J Roentgenol 165 (2):399-403. DOI:10.2214/ajr.165.2.7618566 PMID: 7618566
  2. Shirtliff ME, Mader JT (2002) Acute septic arthritis. Clin Microbiol Rev 15 (4):527-44. PMID: 12364368
  3. Horowitz DL, Katzap E, Horowitz S, Barilla-LaBarca ML (2011) Approach to septic arthritis. Am Fam Physician 84 (6):653-60. PMID: 21916390

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