Septic Arthritis Update

George Ho Jr., MD
Division of Allergy, Immunology and Rheumatology
Department of Internal Medicine
Brody School of Medicine at East Carolina University
Greenville, NC

Risk Factors

Independent risk factors for acute septic arthritis are age greater than 80 years, diabetes mellitus, preexisting rheumatoid arthritis, the presence of a prosthetic joint in the knee or the hip, recent joint surgery, and skin infection (1). A normal joint is very resistant to infection compared to a diseased joint or a prosthetic joint.

An important predisposition to septic arthritis is an impaired immune system. Rheumatoid arthritis (RA), liver cirrhosis, chronic renal failure, and malignancies are often present among patients with septic arthritis. Hemodialysis patients and intravenous drug abusers are predisposed to bacterial joint infection at axial skeleton sites such as the sternoclavicular joint and the sacroiliac joint. Other susceptible hosts are patients with acquired immunodeficiency syndrome, hemophilia, organ transplantation, or hypogammaglobulinemia (2).