Arthritis from joint infection, known by the umbrella term as septic arthritis, can occur from an infection anywhere in the body traveling through the bloodstream. It can also occur from a penetrating injury that delivers germs directly to a joint. An infected joint is usually very tender, swollen, and painful. When caught early and treated with antibiotics it can be cleared of the joint infection. Surgical drainage of the infected joint is often necessary which can be performed arthroscopically. In some cases, the arthritis becomes chronic. Knees are most commonly affected, but septic arthritis also can affect hips, shoulders, and other joints. Often, an infected joint has been affected by another form of arthritis. Gonococcal septic arthritis, transmitted from gonorrhea bacterium, a sexually transmitted disease, can occur in otherwise healthy individuals. Lyme disease is another form of arthritis associated with infection and occurs in certain areas of the country.

The incidence of septic arthritis in industrialized countries, including the US, is estimated at six (2-10) per 100,000 population per year. In persons with underlying joint disease or prosthetic joints, incidence increases to 6-30 per 100,000 per year. The most susceptible populations are young children and the elderly.1 Infection can occur in a prosthetic joint and be a source of chronic pain. Biologics, while shown to work well for RA and other inflammatory arthritis pain, have also been associated with statistically significant higher rates of serious infections as they are designed to weaken the immune system. Serious infections included opportunistic infections as well as bacterial infections in most studies.2 These side effects of increased risk for septic arthritis are recognized and published in numerous sources.

Septic arthritis is included in the “other specific rheumatic conditions” in the AORC discussion.

• 1. Lynn MM, Mathews CJ. Advances in the management of bacterial septic arthritis. International Journal of Clinical Rheumatology 2012;7(3):335-342.
• 2. Singh JA, Wells GA, Christensen R, et al. Adverse effects of biologics: a network meta-analysis and Cochrane overview. Cochrane Library. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD008794.pub2/abstra... Accessed October 24, 2017.