UMEM Educational Pearls

Category: Orthopedics

Title: Adult Septic arthritis

Keywords: MRSA, arthocentesis (PubMed Search)

Posted: 2/22/2014 by Brian Corwell, MD
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The clinical examination is often unreliable in ruling out septic arthritis in the ED.

Diagnostic arthrocentesis is often performed.

Traditional teaching involved very high WBC count thresholds as part of diagnosis.

In one 2009 study, synovial leukocyte counts in cases of MRSA were often less than 25,000 cells/uL

Have a low threshold for empiric antibioitics even in the face of low WBC counts (and incredulous consultants)

How Common is MRSA in Adult Septic Arthritis? Frazee et al., 2009