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Pediatrics
Diagnosis
Musculoskeletal
Infection and Inflammatory Disorders
Septic Arthritis
Septic Arthritis
A. Carlson Merrow, Jr., MD, FAAP
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Definitions

                • Septic arthritis: Microbial (typically bacterial) invasion of joint leading to inflammation & purulence
                • Osteoarticular infection: Osteomyelitis &/or septic arthritis

              IMAGING

              • General Features

                • Radiographic Findings

                  • Ultrasonographic Findings

                    • CT Findings

                      • MR Findings

                        • Imaging Recommendations

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Consider

                                        • Image Interpretation Pearls

                                          Selected References

                                          1. Clever D et al: Pilot study analysis of serum cytokines to differentiate pediatric septic arthritis and transient synovitis. J Pediatr Orthop. 41(10):610-6 2021
                                          2. Erkilinc M et al: Current concepts in pediatric septic arthritis. J Am Acad Orthop Surg. 29(5):196-206, 2021
                                          3. Hamilton EC et al: Children with primary septic arthritis have a markedly lower risk of adverse outcomes than those with contiguous osteomyelitis. J Bone Joint Surg Am. 103(13):1229-37, 2021
                                          4. Royle LN et al: Inflammatory conditions of the pediatric hand and non-inflammatory mimics. Pediatr Radiol. ePub, 2021
                                          5. Ben-Zvi L et al: Diagnosis and management of infectious arthritis in children. Curr Infect Dis Rep. 21(7):23, 2019
                                          6. Brown DW et al: Pediatric septic arthritis: An update. Orthop Clin North Am. 50(4):461-70, 2019
                                          7. Nguyen JC et al: US evaluation of juvenile idiopathic arthritis and osteoarticular infection. Radiographics. 37(4):1181-201, 2017
                                          8. Rosenfeld S et al: Predicting the presence of adjacent Infections in septic arthritis in children. J Pediatr Orthop. 36(1):70-4, 2016
                                          9. Sanpera I et al: Arthroscopy for hip septic arthritis in children. Orthop Traumatol Surg Res. 102(1):87-9, 2016
                                          10. Arnold JC et al: Osteoarticular Infections in Children. Infect Dis Clin North Am. 29(3):557-74, 2015
                                          11. K Schallert E et al: Metaphyseal osteomyelitis in children: how often does MRI-documented joint effusion or epiphyseal extension of edema indicate coexisting septic arthritis? Pediatr Radiol. 45(8):1174-81, 2015
                                          12. Monsalve J et al: Septic arthritis in children: frequency of coexisting unsuspected osteomyelitis and implications on imaging work-up and management. AJR Am J Roentgenol. 204(6):1289-95, 2015
                                          13. Dodwell ER: Osteomyelitis and septic arthritis in children: current concepts. Curr Opin Pediatr. 25(1):58-63, 2013
                                          14. Kanavaki A et al: Can early MRI distinguish between Kingella kingae and Gram-positive cocci in osteoarticular infections in young children? Pediatr Radiol. 42(1):57-62, 2012
                                          15. Kim EY et al: Usefulness of dynamic contrast-enhanced MRI in differentiating between septic arthritis and transient synovitis in the hip joint. AJR Am J Roentgenol. 198(2):428-33, 2012
                                          16. Sultan J et al: Septic arthritis or transient synovitis of the hip in children: the value of clinical prediction algorithms. J Bone Joint Surg Br. 92(9):1289-93, 2010
                                          17. Kwack KS et al: Septic arthritis versus transient synovitis of the hip: gadolinium-enhanced MRI finding of decreased perfusion at the femoral epiphysis. AJR Am J Roentgenol. 189(2):437-45, 2007
                                          18. Yang WJ et al: MR imaging of transient synovitis: differentiation from septic arthritis. Pediatr Radiol. 36(11):1154-8, 2006
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Top Differential Diagnoses

                                                • Pathology

                                                  • Clinical Issues

                                                    • Diagnostic Checklist

                                                      TERMINOLOGY

                                                      • Definitions

                                                        • Septic arthritis: Microbial (typically bacterial) invasion of joint leading to inflammation & purulence
                                                        • Osteoarticular infection: Osteomyelitis &/or septic arthritis

                                                      IMAGING

                                                      • General Features

                                                        • Radiographic Findings

                                                          • Ultrasonographic Findings

                                                            • CT Findings

                                                              • MR Findings

                                                                • Imaging Recommendations

                                                                  DIFFERENTIAL DIAGNOSIS

                                                                    PATHOLOGY

                                                                    • General Features

                                                                      CLINICAL ISSUES

                                                                      • Presentation

                                                                        • Demographics

                                                                          • Natural History & Prognosis

                                                                            • Treatment

                                                                              DIAGNOSTIC CHECKLIST

                                                                              • Consider

                                                                                • Image Interpretation Pearls

                                                                                  Selected References

                                                                                  1. Clever D et al: Pilot study analysis of serum cytokines to differentiate pediatric septic arthritis and transient synovitis. J Pediatr Orthop. 41(10):610-6 2021
                                                                                  2. Erkilinc M et al: Current concepts in pediatric septic arthritis. J Am Acad Orthop Surg. 29(5):196-206, 2021
                                                                                  3. Hamilton EC et al: Children with primary septic arthritis have a markedly lower risk of adverse outcomes than those with contiguous osteomyelitis. J Bone Joint Surg Am. 103(13):1229-37, 2021
                                                                                  4. Royle LN et al: Inflammatory conditions of the pediatric hand and non-inflammatory mimics. Pediatr Radiol. ePub, 2021
                                                                                  5. Ben-Zvi L et al: Diagnosis and management of infectious arthritis in children. Curr Infect Dis Rep. 21(7):23, 2019
                                                                                  6. Brown DW et al: Pediatric septic arthritis: An update. Orthop Clin North Am. 50(4):461-70, 2019
                                                                                  7. Nguyen JC et al: US evaluation of juvenile idiopathic arthritis and osteoarticular infection. Radiographics. 37(4):1181-201, 2017
                                                                                  8. Rosenfeld S et al: Predicting the presence of adjacent Infections in septic arthritis in children. J Pediatr Orthop. 36(1):70-4, 2016
                                                                                  9. Sanpera I et al: Arthroscopy for hip septic arthritis in children. Orthop Traumatol Surg Res. 102(1):87-9, 2016
                                                                                  10. Arnold JC et al: Osteoarticular Infections in Children. Infect Dis Clin North Am. 29(3):557-74, 2015
                                                                                  11. K Schallert E et al: Metaphyseal osteomyelitis in children: how often does MRI-documented joint effusion or epiphyseal extension of edema indicate coexisting septic arthritis? Pediatr Radiol. 45(8):1174-81, 2015
                                                                                  12. Monsalve J et al: Septic arthritis in children: frequency of coexisting unsuspected osteomyelitis and implications on imaging work-up and management. AJR Am J Roentgenol. 204(6):1289-95, 2015
                                                                                  13. Dodwell ER: Osteomyelitis and septic arthritis in children: current concepts. Curr Opin Pediatr. 25(1):58-63, 2013
                                                                                  14. Kanavaki A et al: Can early MRI distinguish between Kingella kingae and Gram-positive cocci in osteoarticular infections in young children? Pediatr Radiol. 42(1):57-62, 2012
                                                                                  15. Kim EY et al: Usefulness of dynamic contrast-enhanced MRI in differentiating between septic arthritis and transient synovitis in the hip joint. AJR Am J Roentgenol. 198(2):428-33, 2012
                                                                                  16. Sultan J et al: Septic arthritis or transient synovitis of the hip in children: the value of clinical prediction algorithms. J Bone Joint Surg Br. 92(9):1289-93, 2010
                                                                                  17. Kwack KS et al: Septic arthritis versus transient synovitis of the hip: gadolinium-enhanced MRI finding of decreased perfusion at the femoral epiphysis. AJR Am J Roentgenol. 189(2):437-45, 2007
                                                                                  18. Yang WJ et al: MR imaging of transient synovitis: differentiation from septic arthritis. Pediatr Radiol. 36(11):1154-8, 2006