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Bacterial arthritis: Clinical features and diagnosis in infants and children

Paul Krogstad, MD
Section Editors
Morven S Edwards, MD
William Phillips, MD
Robert Sundel, MD
Deputy Editor
Mary M Torchia, MD


Infections of the joints (known as septic arthritis, pyogenic arthritis, suppurative arthritis, purulent arthritis, or pyarthrosis) may be caused by bacteria, fungi, mycobacteria, and viruses. The term "septic arthritis" usually refers to bacterial arthritis or fungal arthritis, but bacterial joint infections are most common [1,2].

The clinical features and diagnosis of bacterial arthritis in infants and children will be reviewed here. The epidemiology, pathogenesis, microbiology, treatment, and outcome of bacterial arthritis in infants and children are discussed separately. (See "Bacterial arthritis: Epidemiology, pathogenesis, and microbiology in infants and children" and "Bacterial arthritis: Treatment and outcome in infants and children".)


Bacterial arthritis classically presents with acute onset (two to five days) of fever and joint pain, swelling (picture 1A-B), and limited range of motion. However, the presentation varies depending upon the age of the child, the site of infection, and the causative organism (table 1).

Site of infection — Bacterial arthritis usually occurs in a single joint, most commonly of the lower extremity [2]. Infections of the knee, hip, and ankle consistently account for at least 80 percent of cases, with the hip and knee most commonly affected [2-7]. Bilateral bacterial arthritis of the hip occurs in a small number of cases [8].

Up to 10 percent of cases involve more than one joint [5,9,10]. Polyarticular infections are more common in neonates and with certain pathogens (eg, Neisseria meningitidis, N. gonorrhoeae, and occasionally Staphylococcus aureus) [9,11,12].


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Literature review current through: Sep 2016. | This topic last updated: Oct 12, 2016.
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