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Wheeless' Textbook of Orthopaedics
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Diff Diagnosis of the Septic Arthritis



- See: Synovial F. Exam
       
        - ewing's sarcoma
        - neuroblastoma
        - rheumatoid flare
        - monarticular JRA - knee is less painful, and ROM is > than expected w/ large effusion;
        - acute rheumatic fever: less frequent, more painful with less effusion;
        - toxic synovitis of the hip
        - multiple myeloma (presents w/ strep infection of knee or hip)
        - lyme disease
        - sickle cell crises
        - legg calve perthes disease
        - SCFE
        - gonococcal arthritis
        - adjacent osteomyelitis
        - schonlein-henoch purpura
        - hemophilia
        - gout
        - pseudogout
        - primary menigococcal arthritis:
                - is unusual disease, frequently characterized by erythematous maculopapular or petechial rash & multiple joint involvement w/
                      80-90 % positive joint cultures;
                - frequently an orthopod is asked to see child w/ apparent septic joint who is 5-7 days into ATB Rx for meningo meningitis;
                - these cases often represent an Arthus reaction caused by the newly produced circulating antibodies and bacterial antigens in serum;
                - similar situation is seen following Streptococcal arthritis;









Original Text by Clifford R. Wheeless, III, MD.