Relevance of the Clinical and Laboratory Profile in Decision-making for Patients with Septic Arthritis

Background: 10%–30% of patients with adult-onset septic arthritis septic arthritis had sterile synovial fluid (SF), and it was difficult to diagnose these individuals, making care difficult. The goal of this study was to analyse the variations between persons with proven and suspected septic arthritis.

Methods: A cross-sectional descriptive study was conducted in a tertiary referral facility at King Saud Medical City, Riyadh, Saudi Arabia, from January 2022 to February 2023. After receiving clearance from the institutional ethics board, a practical sample approach was employed. The patients were recruited in the experiment after providing written informed consent. Patients over the age of 18 who had been scheduled for an arthrotomy and joint lavage by the treating surgeon and had clinical symptoms that suggested SA were included in the study. Based on the results of the analysis of the SF and tissue taken during the arthrotomy, the patients were divided into two groups: group 1 (Newman A/confirmed), and group 2 (Newman B and C/suspected).

Results: 40 patients was involved, with 21 patients placed in group 1 and 17 in group 2. The median age of the study population was 49 (36-59), and men dominated both categories (85% and 73%, respectively). Pain was the most common immediate symptom (100%) and was followed by edoema around the injured joint. Except for hip and shoulder swelling, only 25 out of the 28 people who experienced swelling. At the time of admission, a fever was found in 23.8% of patients. Seven patients were on immune-modulative drugs at the time of presentation for a number of ailments, including polymyositis, immune thrombocytopenic purpura, and post-renal transplant.

Conclusion: In order to avoid life-threatening consequences, septic arthritis is an orthopedic emergency that requires immediate and urgent treatment. Similar demographics, clinical characteristics, and laboratory data are present in both confirmed and suspected cases of septic arthritis at presentation, which might lead the treating surgeon. In the case that bacteria cannot be cultured, treatment should be based on solid clinical judgment.