Microbiologic infection and inflammation of the usually sterile joint space
- Most common age: toddler and school age (2–6 years)
- Predominant sex: male (2:1 female)
- Most common location: lower extremities (hip, knee, and ankle) and large joints (hip, shoulder, elbow)
- Entry of bacteria into joint space
- Hematogenous spread (seeding during transient bacteremia) most common
- Direct inoculation (penetrating trauma or during surgery)
- Extension from bone infection (mainly in children <1 year old when vessels cross from metaphysis to epiphysis)
- In response to cytokines, influx of inflammatory cells, and release of proteolytic enzymes
- Leads to destruction of synovium and cartilaginous structures
- Most common causes by age:
- Neonates: group B Streptococcus, Staphylococcus aureus, Escherichia coli, and Candida albicans
- Older children: Staphylococcus aureus, group A Streptococcus, Kingella kingae in toddlers, Haemophilus influenzae
- Also consider
- Salmonella: in patients with sickle cell
- Neisseria gonorrhoeae: in sexually active teens and neonates
- Neisseria meningitidis
- Mycobacterium tuberculosis
- Hepatitis B or C
- Herpesviruses (Epstein-Barr virus, cytomegalovirus, herpes simplex virus, varicella-zoster virus)
- Fungal etiologies (e.g., coccidioidomycosis)
Commonly Associated Conditions
- Sickle cell disease: Salmonella
- Immunocompromised patients: Mycoplasma, Ureaplasma, Klebsiella, or Aspergillus infection
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Cabana, Michael D., editor. "Septic Arthritis." Select 5-Minute Pediatrics Topics, 7th ed., Wolters Kluwer Health, 2015. Medicine Central, im.unboundmedicine.com/medicine/view/Select-5-Minute-Pediatric-Consult/14056/all/Septic_Arthritis.
Septic Arthritis. In: Cabana MDM, ed. Select 5-Minute Pediatrics Topics. Wolters Kluwer Health; 2015. https://im.unboundmedicine.com/medicine/view/Select-5-Minute-Pediatric-Consult/14056/all/Septic_Arthritis. Accessed June 7, 2023.
Septic Arthritis. (2015). In Cabana, M. D. (Ed.), Select 5-Minute Pediatrics Topics (7th ed.). Wolters Kluwer Health. https://im.unboundmedicine.com/medicine/view/Select-5-Minute-Pediatric-Consult/14056/all/Septic_Arthritis
Septic Arthritis [Internet]. In: Cabana MDM, editors. Select 5-Minute Pediatrics Topics. Wolters Kluwer Health; 2015. [cited 2023 June 07]. Available from: https://im.unboundmedicine.com/medicine/view/Select-5-Minute-Pediatric-Consult/14056/all/Septic_Arthritis.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Septic Arthritis ID - 14056 ED - Cabana,Michael D, BT - Select 5-Minute Pediatrics Topics UR - https://im.unboundmedicine.com/medicine/view/Select-5-Minute-Pediatric-Consult/14056/all/Septic_Arthritis PB - Wolters Kluwer Health ET - 7 DB - Medicine Central DP - Unbound Medicine ER -