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Related Experiment Videos

Septic and aseptic arthritis: a continuum?

D Taylor-Robinson1, A Keat

  • 1Department of Genito-Urinary Medicine, St Mary's Hospital, London, UK.

Bailliere'S Best Practice & Research. Clinical Rheumatology
|August 23, 2000
PubMed
Summary

A spectrum of infection-provoked arthritis, from overt sepsis to chronic forms with minimal bacteria, is proposed. Criteria are suggested for identifying bacteria causing joint inflammation, challenging conventional views of sterile joints.

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Area of Science:

  • Rheumatology
  • Infectious Diseases
  • Microbiology

Background:

  • Joints are conventionally considered sterile.
  • Detecting low levels of bacteria in chronic arthritis is challenging.
  • The spectrum of infectious arthritis is not fully understood.

Purpose of the Study:

  • To explore the spectrum of infection-provoked arthritis.
  • To question the assumption of sterile joints in all cases.
  • To propose criteria for identifying causative microorganisms in arthritis.

Main Methods:

  • Review of known septic, probable infective, and aseptic arthritis cases.
  • Consideration of bacterial detection methods, including highly sensitive techniques.
  • Development of criteria for attributing causality to microorganisms.

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Main Results:

  • Evidence suggests a wide spectrum of arthritis linked to bacterial presence.
  • Even 'aseptic' arthritis may involve low bacterial loads.
  • Proposed criteria aid in evaluating the significance of detected bacteria.

Conclusions:

  • Arthritis can arise from a broad range of bacterial infections.
  • The presence of microorganisms, even in small numbers, can be significant in arthritis.
  • A framework is provided for diagnosing infection-related arthritis.