A prospective 2-year study of 75 patients with adult-onset septic arthritis

Rheumatology (Oxford). 2001 Jan;40(1):24-30. doi: 10.1093/rheumatology/40.1.24.


Aims and methods: To assess the clinical features of septic arthritis and characterize therapeutic strategies and outcome in a prospective study of 75 patients selected by positive synovial fluid culture.

Results: Underlying joint disease was present in 46 patients, 25 of whom had rheumatoid arthritis and 15 osteoarthritis. Eleven patients were i.v. drug abusers. Fifty-six per cent of cases involved the knee, 15% involved two or more joints, and staphylococci and streptococci were cultured in >90%. Seventy-eight per cent of patients lived in areas of high social deprivation. Fever was present in 64% and the white cell count (WCC) was normal in 38%. The C-reactive protein was elevated in 98%. Leg ulcers were present in 11% of all patients but in 38% of patients who died (P<0.006). Median duration of antibiotic therapy was 15 days i.v. with subsequent oral treatment for 21 days. Thirty-seven per cent of cases required surgical intervention. Mortality was 11%. A raised WCC at presentation (P<0.02) and the development of abnormal renal function (P<0.015) were predictors of poor prognosis.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial
  • Multicenter Study

MeSH terms

  • Age of Onset
  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Antirheumatic Agents / therapeutic use*
  • Arthritis, Infectious / drug therapy*
  • Arthritis, Infectious / epidemiology
  • Arthritis, Infectious / microbiology
  • Arthritis, Infectious / physiopathology
  • Arthritis, Infectious / surgery
  • Bacterial Infections / drug therapy
  • Female
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Male
  • Middle Aged
  • Prospective Studies
  • Risk Factors
  • Social Class
  • Treatment Outcome


  • Anti-Bacterial Agents
  • Antirheumatic Agents
  • Immunosuppressive Agents