musculoskeletal and connective tissue disorders
Acute Infectious Arthritis
Key Points
Gonococcal arthritis manifests with less severe acute inflammation than does acute nongonococcal bacterial arthritis. Suspect infectious arthritis if patients have acute monarticular or oligoarticular arthritis, particularly patients at risk, or findings suggesting other particular infectious arthritis syndromes. Test and culture synovial fluid to confirm or exclude the diagnosis; x-rays and routine laboratory studies are usually of little help. Diagnose and treat infectious arthritis, particularly nongonococcal bacterial arthritis, as soon as possible. Direct initial antibiotic therapy at pathogens suspected based on clinical and Gram stain findings. Nongonococcal joint infections should be drained; gonococcal joint infections should be drained if they cause persistent effusion. 