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Journal of Bone and Joint Surgery, 1974;56:1180-1184.
© 1974 by The Journal of Bone and Joint Surgery, Inc

Spontaneous Septic Arthritis Complicating Rheumatoid Arthritis

ANTHONY G. GRISTINA M.D.1, GEORGE D. ROVERE M.D.1, and HIROMU SHOJI M.D.1

1 From the Section of Orthopedic Surgery, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem

Thirteen cases (in twelve patients) of septic arthritis complicating rheumatoid arthritis are reported. One ankle, one metacarpophalangeal joint, one shoulder, and ten knees were involved. Staphylococcus aureus was cultured from twelve joints and Escherichia coli, from one. Treatment consisted of repeated needle aspirations in two patients, arthrotomy with Penrose drainage in six, and arthrotomy with through-and-through irrigation in four. Needle aspiration was the least effective therapy. The authors recommend as the treatment of choice: systemic antibiotic therapy and immediate arthrotomy followed by through-and-through irrigation with fluid containing the appropriate antibiotics.


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