Septic Arthritis Differential Diagnosis

Septic arthritis is a condition in which a joint is infected. This severely painful infection is typically bacterial, but there are fungal causes as well. In some cases, only the joint is infected, while in others, the entire body can become infected. When the cause is bacterial, the knee is most often affected, but joints in the ankle, elbow, shoulder, wrist, and hip may also be affected. The infection may cause joint damage, warmth, swelling, and severe pain, as well as systemic symptoms, such as fever. A septic arthritis differential diagnosis involves taking evidence to come to a concrete diagnosis. During the process, the patient will discuss their symptoms with their doctor, be examined, and undergo medical testing. The doctor will take all of this information (the evidence) and use it to make a definitive diagnosis through eliminating all possibilities except one. It is estimated that about 20,000 Americans experience septic arthritis each year, says Patient UK.

Gout

When making a septic arthritis differential diagnosis, gout is often considered since some of the signs and symptoms are the same. Patients experience gout when uric acid accumulates in their joints. This type of arthritis occurs when a patient has too much uric acid in their body. Gout can be acute or chronic. Signs and symptoms may include painful, red, and warm affected joints. Fever may also occur. The pain can get to the point of being excruciating. Lifestyle changes are often necessary to prevent future attacks. Symptoms may be controlled with corticosteroids, non-steroidal anti-inflammatory drugs, narcotic pain medications, or colchicine. To reduce blood-uric acid levels, using allopurinol or probenecid is often helpful.

Reactive Arthritis

Reactive arthritis involves the joints, eyes, and urethra. It is actually a group of inflammatory disorders. Mucus membrane and skin lesions may also be present. What causes this type of arthritis is not known, but certain genes may play a role. It may also occur after certain infections, such as chlamydia, salmonella, yersinia, or campylobacter. Symptoms may include pain in the affected joints, heel, lower back, or Achilles tendon. Eye symptoms may include discharge, pain, and redness. Other symptoms may include urinary hesitancy or urgency, skin lesions, male genital lesions, oral ulcers, incontinence, penis pain, burning during urination, and urethral discharge. Treatment focuses on treating the underlying condition and controlling symptoms. This may include antibiotics, pain-relieving medications, immunosuppressants, and physical therapy.

Vasculitis

Vasculitis is a condition characterized by inflamed blood vessels. This condition can be either acute or chronic. Sometimes the cause is not known, but when the cause is identifiable it may be due to infections, allergic reactions, immune system diseases, or blood cell cancers. The type of vasculitis that is present will determine the treatment used. Some types require no treatment at all, while others may require steroids to keep the inflammation under control or immunosuppressants.

Resources

MayoClinic.com. (2010). Septic Arthritis. Retrieved on November 15, 2010 from MayoClinic.com: https://www.mayoclinic.com/health/bone-and-joint-infections/DS00545

Patient UK. (2010). Septic Arthritis. Retrieved on November 15, 2010 from Patient UK: https://www.patient.co.uk/doctor/Septic-Arthritis.htm