Action
- Consider bursitis, pathologic fracture
- Obtain x-ray (Class II)
Decision
Is the patient systemically ill, in a high-risk population for septic joint, or with poor medical access?
Yes
- Provide antibiotics and admit
No
- Admit and/or observe or
- Recommend close follow-up
Background
Historical Factors Indicating Risk of Septic Arthritis
- Presence of fever AND joint pain
- Immunosuppression
- History of rheumatoid arthritis or a prosthetic joint
- History of skin or soft-tissue infection
- Severe pain with joint range of motion
- Pre-existing joint disease or recent joint surgery
A patient with any of these characteristics has an increased chance of having septic arthritis, and arthrocentesis should be considered.
