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Your guide to septic arthritis

Person holdng their leg in pain

Septic arthritis is a bacterial infection that causes a severe inflammation in one or more of the joints, most commonly the hips or knees.

It is vital that a patient receives an early, accurate diagnosis and emergency treatment to help prevent the significant worsening of the condition. If a patient is left untreated, septic arthritis can quickly spread, causing permanent and severe joint damage which can result in the amputation of the affected limb.  In some cases, septic arthritis can be life threatening.

Late or missed diagnosis 

If you or member of you family believe that you have not been given the duty of care you were owed, talk to Your Legal Friend.  We will consider your case fully and, if we believe that there are questions surrounding your treatment, we will investigate a medical negligence claim.

Our dedicated team of specialist solicitors has years of experience in successfully resolving many different types of clinical negligence cases. We can help you find out why things went wrong and, crucially, obtain the compensation you deserve to meet the cost of all necessary care, treatment, special equipment and support both now and in the future.

How common is septic arthritis?

  • 45% of septic arthritis sufferers are over 65 years old and are more likely to have multiple diseases.                                                                       (Medscape from WebMD)  

  •  56% of septic arthritis patients are male.                                (Medscape from WebMD) 
  • Between 1.5 and 2.5% of joint infections are caused by an increase in antibiotic-resistant organisms during a first procedure.                                      (Epub, 2010)  
  • Up to 20% of joint infections are caused by an increase in antibiotic-resistant organisms during further procedures.                                     (Epub, 2010)                                                  
  • At least 2 – 10% of patients fitted with a prosthetic limb suffer prosthetic joint infection (PJI)                       (Clin.Infect.Dis. - Nov, 2013)                                                           
  • There are an estimated 20,000 cases of acute bacterial arthritis per year in both the US and Europe.                                                       (Oct 2007)

What causes septic arthritis?

  • Bacteria entering a wound and travelling through the bloodstream to the affected joint is the most common cause of septic arthritis.
  • Following an injury / skin infection
  • During surgery
  • Previously damaged joints, especially if caused by rheumatoid arthritis
  • Reactive arthritis - caused by bacteria involving the body’s immune system, most commonly gastrointestinal (stomach/bowels) but also genitor-urinary infections, especially those caused by Chlamydia. Other types of bacteria include Salmonella, Campylobacter and Clostridium Difficile - C-diff (linked with antibiotics).
  • Prosthetic joint infections (PJIs) – caused by local infections acquired in the operating room, which could be:
      • Early - within 3 months of attachment
      • Delayed - within 3-24 months of attachment
      • Later – after 24 months of attachment

Other risk factors include:

  • Increasing age
  • Diabetes
  • Infection with HIV

Symptoms of septic arthritis

The symptoms of septic arthritis usually develop rapidly including:

  • Joint swelling
  • Intense pain in the affected joint
  • Inability to move the limb with the infected joint
  • Warmth - red and warm to touch
  • Fever and chills
  • Fatigue and weakness

Diagnosing septic arthritis

If an experienced doctor or GP suspects septic arthritis, they should immediately refer the patient to hospital for further examination and the following clinical tests:

Arthrocentesis – a surgical puncture of the joint using a needle and syringe to take a sample of the joint lubricant, known as synovial fluid.

The fluid is sent to a laboratory and analysed to determine:

  • Inflammation and infection – by an increased number of white blood cells.
  • Type of bacteria - and susceptibility to a variety of antibiotics.

In many cases the results of the above tests will be ‘normal’, so cannot be relied upon to rule out infection.

Blood tests - are also frequently used to make a white blood cell count and detect inflammation throughout the body.

Imaging tests - can sometimes be used to help confirm a diagnosis:

  • X-ray image - of the joint can help to detect injury of the bone adjacent to the joint and may show a slight increase in joint space tissue swelling.
  • MRI scan - to evaluate the extent of joint fluid or effusion, joint damage and abnormalities in the bone marrow.  Detection sensitivity is around 67% and specific detection is around 98%.
  • Ultrasound - to detect swelling of the joints.

Treatment of septic arthritis

Septic arthritis must be urgently treated by admittance to hospital, usually for at least two weeks, to undergo a course of antibiotics to prevent the rapid spread of the infection. These antibiotics are directly injected into the veins. An orthopaedic surgeon may also drain the infected joint using a needle and syringe.

If the infection has reached an advanced stage, an emergency ‘surgical washout’ may be needed to preserve the joint and prevent further deterioration which could lead to the amputation of the affected limb.

Once the course of intravenous antibiotics is complete, further antibiotic tablets will need to be taken at home for at least another four weeks.

A complete recovery should be made although some people could still experience persistent limited movement in the affected joint.

Septic arthritis – do I have grounds for a negligence claim?

If you or a member of your family suffered harm due to a medical error, you need to know why you were so badly let down by those entrusted to take care of you.  For example, 

To prove a successful clinical negligence claim

You need to:

  • Show that the treatment you received fell below a standard that a reasonable body of medical opinion would find acceptable. 
  • Establish that if there had not been a ‘breach of duty’, the damage or injury would not have occurred.

How Your Legal Friend can help you

Your Legal Friend is committed to ensuring that victims of clinical negligence obtain answers and that the hospital, health trust or medical practitioner is brought to account for the harm and suffering they have caused.  Above all, we ensure that you receive appropriate compensation for your pain, suffering and loss of quality of life. If an amputation took place, your compensation will reflect the devastating, life changing impact that this has had.

Compensation should also restore your financial position before the negligence occurred, covering vital needs, such as:

  • Loss of earnings and pension.
  • Any medical, rehabilitation, and care costs.
  • Accommodation  costs
  • Prosthetics.