Acute Arthritis in Children: How to Discern between Septic and Non-Septic Arthritis?

Abstract

The term septic arthritis refers to an infection of the synovial space. This is an infrequent condition in healthy children, but it should be considered a medical emergency potentially leading to irreversible articular damage. Therefore, prompt diagnosis and antimicrobial treatment play a crucial role in improving the prognosis. Although septic arthritis is the most common cause of acute arthritis, many other diseases may mimic a similar clinical picture, constituting a diagnostic challenge for the clinician who first approaches the patient. Herein we analyze the main features of septic arthritis, offering an overview of the main conditions involved in the differential diagnosis and suggesting a diagnostic workup plan.

Surgical (over) treatment of pediatric Lyme arthritis: a need for faster Borrelia testing

“…Systemic juvenile idiopathic arthropathy commonly presents with rashes, headaches, and pericarditis [28]. Cancers can present with hepatosplenomegaly and multiple locations of lymphadenopathy [27]. Systemic lupus erythematous commonly presents with a malar rash and mucositis [29].…”

“…In addition to Lyme arthritis, there are many additional mimickers of septic arthritis. Reactive arthritis secondary to enteric pathogens or immunizations and cancers including lymphoma and leukemia can also present with fever and acute joint pain [27]. Inflammatory arthropathy can present with fever, elevated CRP, and monoarthritis, as well [27].…”

“…Reactive arthritis secondary to enteric pathogens or immunizations and cancers including lymphoma and leukemia can also present with fever and acute joint pain [27]. Inflammatory arthropathy can present with fever, elevated CRP, and monoarthritis, as well [27]. For example, patients with systemic juvenile idiopathic arthropathy are commonly febrile to 102°F [28].…”

Sore knee – why and when to call a cardiologist

“…Importantly, microbial blood and aspirate testing will be negative and the clinical course will be self-limited. Treatment is symptomatic relief with analgesia and rest 17…”

The Past, Present, and Future of Kingella kingae Detection in Pediatric Osteoarthritis

“…Because of the lack of timely laboratory information, broad antimicrobial therapy is usually administered to cover the unknown agent of the infection. Failure to detect a bacterial pathogen could result from misdiagnosing viral or reactive arthritis and medical conditions that mimic osteoarticular infections such as rheumatologic or metabolic disorders, trauma, or malignancy [ 7 , 8 , 9 ]. Yet, the possibility that a negative culture could be caused by microorganisms that traditional laboratory techniques cannot isolate should also be considered.…”