Septic arthritis


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Septic arthritis

Musculoskeletal system

Pediatric musculoskeletal conditions

Radial head subluxation (Nursemaid elbow)

Developmental dysplasia of the hip

Legg-Calve-Perthes disease

Slipped capital femoral epiphysis

Transient synovitis

Osgood-Schlatter disease (traction apophysitis)

Musculoskeletal injuries and trauma

Rotator cuff tear

Dislocated shoulder

Radial head subluxation (Nursemaid elbow)

Winged scapula

Thoracic outlet syndrome

Carpal tunnel syndrome

Ulnar claw

Erb-Duchenne palsy

Klumpke paralysis

Iliotibial band syndrome

Unhappy triad

Anterior cruciate ligament injury

Patellar tendon rupture

Meniscus tear

Patellofemoral pain syndrome

Sprained ankle

Achilles tendon rupture



Degenerative disc disease

Spinal disc herniation


Compartment syndrome


Bone disorders

Osteogenesis imperfecta


Pectus excavatum


Genu valgum

Genu varum

Pigeon toe

Flat feet

Club foot

Cleidocranial dysplasia



Bone tumors




Osteomalacia and rickets


Paget disease of bone


Lordosis, kyphosis, and scoliosis

Joint disorders



Spinal stenosis

Rheumatoid arthritis

Juvenile idiopathic arthritis


Calcium pyrophosphate deposition disease (pseudogout)

Psoriatic arthritis

Ankylosing spondylitis

Reactive arthritis


Septic arthritis


Baker cyst

Muscular disorders

Muscular dystrophy



Inclusion body myopathy

Polymyalgia rheumatica



Neuromuscular junction disorders

Myasthenia gravis

Lambert-Eaton myasthenic syndrome

Other autoimmune disorders

Sjogren syndrome

Systemic lupus erythematosus

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Antiphospholipid syndrome

Raynaud phenomenon


Limited systemic sclerosis (CREST syndrome)

Musculoskeletal system pathology review

Back pain: Pathology review

Rheumatoid arthritis and osteoarthritis: Pathology review

Seronegative and septic arthritis: Pathology review

Gout and pseudogout: Pathology review

Systemic lupus erythematosus (SLE): Pathology review

Scleroderma: Pathology review

Sjogren syndrome: Pathology review

Bone disorders: Pathology review

Bone tumors: Pathology review

Myalgias and myositis: Pathology review

Neuromuscular junction disorders: Pathology review

Muscular dystrophies and mitochondrial myopathies: Pathology review


Septic arthritis


0 / 9 complete

USMLE® Step 1 questions

0 / 3 complete

High Yield Notes

4 pages


Septic arthritis

of complete


USMLE® Step 1 style questions USMLE

of complete

A 35-year-old man presents to his primary care physician’s office for evaluation of right knee and ankle pain for the past 2 days. He had similar pain over the left wrist and shoulder joints in the past year that self resolved. The patient has a painless rash on his hands which appeared around the same time. Past medical history is significant for a urinary tract infection 2 months ago which was treated with antibiotics. He has had 7 sexual partners over the past year and is currently sexually active. He uses condoms inconsistently. He denies any recent travel. His temperature is 38.2 °C (100.8°F), pulse is 80/minute, respirations are 16/minute, and blood pressure is 130/80 mmHg. Physical examination shows multiple nontender papulovesicular lesions on his hands. Passive flexion of wrists elicits a sharp pain. Which best describes the route of transmission regarding the causative organism resulting in this patient’s clinical condition?  

External References

First Aid








Neisseria gonorrhoeae p. , 140

septic arthritis p. 478

Pustules p. 489

with septic arthritis p. 478

Septic arthritis p. 478

gonococci p. 140

Staphylococcus aureus p. , 133

Staphylococcus aureus p. , 133

septic arthritis p. 478

Streptococcus spp.

septic arthritis p. 478


Content Reviewers

Rishi Desai, MD, MPH


Evode Iradufasha, MD

Alex Aranda

Septic arthritis, also called infectious arthritis, refers to any joint inflammation caused by a microbe - and usually it results from a bacterial infection of the joint.

All types of joints; fibrous, cartilaginous, and synovial joints can get infected. So let’s just use the synovial type as an example.

A synovial joint consists of a joint capsule which has an outer fibrous layer, and an inner synovial membrane filled with synovial fluid.

The synovial fluid is a clear viscous fluid that looks like the white of an egg, and it helps lubricate the joint and absorb shock.

The synovial membrane has blood vessels that supply the joint with nutrients and oxygen.

The tips of the bones that come together to form the joints are covered by an articular cartilage, which is a slippery smooth layer of cartilage that also absorbs shock and reduces friction during movement.

Now, there are various ways by which a bacterium can get into your joint.

First, it can be from a preexisting infection in adjacent tissue, usually the bone, from where a bacterial infection can spread to the articulating part of the bone and then makes its way right into the joint.

It can also develop from hematogenous spread which is where the bacteria is somewhere else in the body like the lungs, and then travels through the bloodstream and gets into the joint.

So, let’s say a child falls on some dirty planks of wood and a nail pierces through their knee, infecting the synovial membrane with bacteria.

That bacteria could either come from the nail and be living in the environment, like Clostridium tetani which causes tetanus, or it could be bacteria that lives on the skin surface and gets shoved deep into the joint at the moment that the skin is pierced, like Staphylococcus aureus.

Once bacteria get into the synovial cavity, they start destroying the articular cartilage with their toxins.

One example of a toxin is chondrocyte proteases, which is a powerful enzyme that’s capable of digesting the collagen in the articular cartilage.


Septic arthritis is a type of joint infection that occurs when a microorganism, typically a bacteria, invades the joint and causes inflammation and tissue damage. The invading bacteria may be carried by the bloodstream from an infectious focus elsewhere; introduced through a skin lesion and penetrates the joint; or arrive in the joint by extension from adjacent infected tissue. People with septic arthritis typically develop joint pain, impaired range of motion, and fever. The diagnosis involves getting a joint aspirate and imaging, and treatment includes antibiotics and surgical management. If untreated, septic arthritis may lead to joint destruction, or even cause the infection may also spread to other parts of the body.


  1. "Robbins Basic Pathology" Elsevier (2017)
  2. "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
  3. "Pathophysiology of Disease: An Introduction to Clinical Medicine 8E" McGraw-Hill Education / Medical (2018)
  4. "CURRENT Medical Diagnosis and Treatment 2020" McGraw-Hill Education / Medical (2019)
  5. "Evidence-based Diagnostics: Adult Septic Arthritis" Academic Emergency Medicine (2011)
  6. "Does This Adult Patient Have Septic Arthritis?" JAMA (2007)
  7. "Acute Septic Arthritis" Clinical Microbiology Reviews (2002)

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