Septic arthritis. Clinical approach to the 'hot joint'

Joint space infections continue to be among the most common forms of arthritis. Diagnosis can be difficult, particularly in the presence of underlying joint disease. Septic arthritis should be suspected in all patients who present with an acutely swollen joint. Immediate joint aspiration with Gram's stain and culture of the synovial fluid is essential. Intensive, long-term antibiotic therapy is necessary to prevent a high rate of morbidity and, possibly, death.