Septic arthritis physical examination

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]

Patients with septic arthritis usually appear toxic.Common physical examination findings of septic arthritis include erythema, warmth, swelling, tenderness and decreased range of motion over the affected joint, usually knee.

• Patient with septic arthritis usually appears toxic and with joint pain
• children usually appear irritable

• Low grade fever. Chills and spiking fever are very rare.
• Hyperthermia over the joint involved
• Tachycardia
• Tachypnea

• Warmth over the joint

• Erythema over the around the joint that involved
• Disseminated gonococcal infection often present with skin lesions, typically multiple, painless macules and papules, most often found on the arms or legs or on the trunk.^[1]

Most commonly involves knee > hip > shoulder > ankle.^[2] Other joints such as sacroiliac joint (~10%), sternoclavicular or costoclavicular joints may be involved in patient with history of intravenous drug abuse (IVDA), penetrating trauma, animal or human bites and local steroid injections.

• Swelling of the joint that involved
• Decreased range of motion such as pseudo paralysis
• Patient hold the hip in flexed and externally rotated position if SA involving hip.
• If child, unwillingness to bear weight on the affected joint (antalgic gait)

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