Article Text

other Versions

Management of septic arthritis – A systematic review
  1. C J Mathews (catherinemathews{at}
  1. Queen Elizabeth Hospital, Woolwich, London, United Kingdom
    1. G Kingsley (gabrielle.kingsley{at}
    1. University Hospital Lewisham and King's College Hospital, London, United Kingdom
      1. M Field (m.field{at}
      1. Centre for Rheumatic Diseases, Glasgow, United Kingdom
        1. A Jones (ajones{at}
        1. Rheumatology Unit, Nottingham University Hospitals, United Kingdom
          1. V C Weston
          1. University Hospital NHS Trust, Queen’s Medical Centre, Nottingham, United Kingdom
            1. M Phillips (mark.phillips{at}
            1. King’s College Hospital, London, United Kingdom
              1. D Walker (david.walker{at}
              1. Musculoskeletal Unit, Freeman Hospital, Newcastle upon Tyne, United Kingdom
                1. G Coakley (gerald.coakley{at}
                1. Queen Elizabeth Hospital, Woolwich, London, United Kingdom


                  Objective: To evaluate the existing evidence on the diagnosis and management of septic arthritis in native joints.

                  Design: Systematic Review.

                  Data Sources: Cochrane Library, Medline, Embase, National Electronic Library for Health, reference lists, national experts.

                  Review methods: Systematic review of the literature with evaluation of the methodological quality of the selected papers using defined criteria set out by the Clinical Effectiveness and Evaluation Unit of the Royal College of Physicians.

                  Results: 3291 citations were initially identified. Of these, 189 full text articles were identified for potential selection. Following review of these 80 articles fulfilled inclusion criteria and were in the final list. Conclusions were drawn on the diagnosis, investigation and management of septic arthritis.

                  Discussion: Little good quality evidence exists to guide the diagnosis and management of septic arthritis. Overall, no investigation is more reliable in the diagnosis of septic arthritis than the opinion of an experienced clinician. Aspiration and culture of synovial fluid is crucial to the diagnosis, but measurement of cell count is unhelpful. Antibiotics are clearly required for a prolonged period, but there are no data to indicate by which route or for how long. Key unanswered questions remain surrounding the medical and surgical management of the infected joint.

                  • septic arthritis
                  • systematic literature review

                  Statistics from

                  Request permissions

                  If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.