Epidemiology

The estimated incidence of septic arthritis in developed countries is 6 cases per 100,000 population per year.[1] In patients with underlying joint disease or with prosthetic joints the incidence increases approximately 10-fold, to 70 cases per 100,000 of the population.[2]

Risk factors

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underlying joint disease

The presence of underlying joint disease, such as osteoarthritis or rheumatoid arthritis, predisposes the affected joint to the development of infection if pathogens are introduced.[3][8][9][10]

prosthetic joint

Prosthetic material increases the risk of joint sepsis.[8][9]

age

Age over 80 years is associated with an increased risk of septic arthritis.[8][9]

immunosuppression

Intravenous drug misuse

  • Recurrent needle puncture of the skin to achieve intravenous access increases the likelihood of transfer of pathogenic skin organisms into the bloodstream and subsequent seeding of infection into the joint.[9][10][11]

HIV[9][11]

Diabetes[8][9][10][12]

Alcohol misuse[10]

Immunosuppressive medication[3][10][11]

contiguous spread

  • Cutaneous ulcers or skin infection[3][8][9][10]

    • Can lead to bacteraemia and subsequent seeding of infection in a joint.

exposure to ticks

Travel to or residence in areas where Lyme disease is prevalent may indicate arthritis associated with Lyme disease.[14]

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previous intra-articular corticosteroid injection

Intra-articular corticosteroid injection may be a route through which infection could be introduced into a joint, leading to joint sepsis.[13]

recent joint surgery

Surgery may predispose to local infection.[8][9][12]

low socioeconomic status

Associated with a higher risk of septic arthritis.[4][10]

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