Diff Diagnosis of the Septic Arthritis : Wheeless' Textbook of Orthopaedics

- 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
- leukemia
- An unusual orthopaedic presentation of acute lymphoblastic leukemia.
- 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;

            - lyme disease
- osteomyelitis
            - references:
                   - Clinical features of pseudogout attack. A survey of 50 cases.
                   - Staphylococcal septic arthritis presenting as acute flare of pseudogout: clinical, pathological and arthroscopic findings with a review of the literature.
                   - Acute pseudogout mimicking septic arthritis following urologic manipulation
    - radioisotope scanning
        - Gallium scintigraphy for diagnosis of septic arthritis and osteomyelitis in children.
                   - Prospective comparative study of patients with culture proven and high suspicion of adult onset septic arthritis.