• Due to seeding of joint during bacteremia, most commonly Staphylococcus, Streptococcus, gram negative rods; rarely syphilis
• Also due to postsurgical infection
• Neonates: often due to osteomyelitis; hip more common than ankle or knee
• Young women: usually gonorrhea, associated with multiple joint involvement, including knee
• Sickle cell disease: Salmonella
• Risk factors: immune deficiencies, severe illness, joint trauma, chronic arthritis, intravenous drug abuse
• Symptoms: sudden development of acutely painful and swollen joint with restricted range of motion, systemic findings

• Usually single joint (knee, hip, shoulder)

• Aspiration of joint under radiologic guidance

• 38 year old man with septic arthritis due to Staphylococcus warneri (Open Rheumatol J 2012;6:310)
• 40 year old man with septic arthritis of hip due to Salmonella typhi (Case Rep Infect Dis 2012;2012:464527)
• 53 year old woman with isolated septic facet joint arthritis (Pol J Radiol 2012;77:72)
• 66 year old man with septic arthritis of knee associated with calf abscess (J Orthop Surg (Hong Kong) 2012;20:272)

• Immediate surgical incision and drainage, immobilization and antibiotics

Ankle joint

• Neutrophils (also Bechet's disease, familial Mediterranean fever)

Pyogenic osteomyelitis and suppurative arthritis leading to joint destruction

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