Comparison of Septic Arthritis and Reactive Arthritis


FeatureSeptic ArthritisReactive Arthritis
Joint InvolvementMonoarthritis (single joint, commonly the knee)Migratory oligoarthritis (lower limbs, knees, and ankles)
SymptomsFever, pain, swelling, limited movement, warmth of jointPainful joints, back pain, no fever, extra-articular symptoms
Risk FactorsSteroid use, rheumatoid arthritis, diabetes mellitusRecent urogenital or gastrointestinal infection
Causative OrganismsStaphylococcus aureus (most common), N. gonorrhea (in young, sexually active individuals)No specific organism, often post-infectious
DiagnosisAspiration of synovial fluid (staining, microscopy, WBC count, culture), blood cultureClinical diagnosis, supported by recent infection history
ManagementFlucloxacillin (first-line), clindamycin (if penicillin allergic), cefotaxime or ceftriaxone for gonococcal infections, repeated percutaneous aspiration if neededSymptomatic treatment (analgesia, NSAIDs, intra-articular steroids), sulfasalazine and methotrexate for persistent cases
Duration of TreatmentIV antibiotics for 1 week until blood cultures are negative, followed by oral antibiotics for 4 weeksSymptoms rarely last more than 12 months
Extra-articular FeaturesNot typicalConjunctivitis, uveitis, urethritis (Reiter’s triad), skin manifestations (circinate balanitis, keratoderma blenorrhagica, erythema nodosum)

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