{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T17:20:21Z","timestamp":1789665621390,"version":"4.0.1"},"reference-count":65,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Semin Musculoskelet Radiol"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Septic arthritis is a major cause of morbidity and mortality worldwide, with survivors often facing long-term functional impairments. Prompt diagnosis is crucial to decrease complications such as cartilage loss, osteomyelitis, and reduced mobility. Imaging plays a central role in the diagnosis, as well as offering guidance for diagnostic aspiration. Because septic arthritis may involve any joint in the body, both native and prosthetic, different imaging modalities may be more applicable in various scenarios. We describe the hallmark imaging findings of septic arthritis in radiography, ultrasound, computed tomography, magnetic resonance imaging, and nuclear medicine scintigraphy, as well as the associated complications.<\/jats:p>","DOI":"10.1055\/s-0045-1802352","type":"journal-article","created":{"date-parts":[[2025,3,31]],"date-time":"2025-03-31T22:36:59Z","timestamp":1743460619000},"page":"293-301","source":"Crossref","is-referenced-by-count":10,"title":["Septic Arthritis: Current Concepts"],"prefix":"10.1055","volume":"29","author":[{"given":"Bryce D.","family":"Beutler","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Southern California, Keck School of Medicine, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carina","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Johns Hopkins Bayview Medical Center, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8005-9538","authenticated-orcid":false,"given":"Ellen Y.","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of California, San Francisco, San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,3,31]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"1193645","DOI":"10.3389\/fcimb.2023.1193645","article-title":"An update on recent progress of the epidemiology, etiology, diagnosis, and treatment of acute septic arthritis: a review","volume":"13","author":"M He","year":"2023","journal-title":"Front Cell Infect Microbiol"},{"issue":"11","key":"ref2","doi-asserted-by":"crossref","first-page":"1087","DOI":"10.1080\/14787210.2016.1235973","article-title":"Septic arthritis in children in resource limited and non-resource limited countries: an update on diagnosis and treatment","volume":"14","author":"E Chiappini","year":"2016","journal-title":"Expert Rev Anti Infect Ther"},{"issue":"03","key":"ref3","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1017\/S0950268800059070","article-title":"An 18 year clinical review of septic arthritis from tropical Australia","volume":"117","author":"D S Morgan","year":"1996","journal-title":"Epidemiol Infect"},{"issue":"01","key":"ref4","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1093\/rheumatology\/40.1.24","article-title":"A prospective 2-year study of 75 patients with adult-onset septic arthritis","volume":"40","author":"M N Gupta","year":"2001","journal-title":"Rheumatology (Oxford)"},{"issue":"03","key":"ref5","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1016\/S1473-3099(19)30419-0","article-title":"Mortality and adverse joint outcomes following septic arthritis of the native knee: a longitudinal cohort study of patients receiving arthroscopic washout","volume":"20","author":"S GF Abram","year":"2020","journal-title":"Lancet Infect Dis"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1186\/s12879-016-1540-0","article-title":"Morbimortality in adult patients with septic arthritis: a three-year hospital-based study","volume":"16","author":"J Ferrand","year":"2016","journal-title":"BMC Infect Dis"},{"issue":"02","key":"ref7","doi-asserted-by":"crossref","first-page":"331","DOI":"10.5811\/westjem.2018.10.40974","article-title":"Evaluation and management of septic arthritis and its mimics in the emergency department","volume":"20","author":"B Long","year":"2019","journal-title":"West J Emerg Med"},{"issue":"08","key":"ref8","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1111\/j.1553-2712.2011.01121.x","article-title":"Evidence-based diagnostics: adult septic arthritis","volume":"18","author":"C R Carpenter","year":"2011","journal-title":"Acad Emerg Med"},{"issue":"12","key":"ref9","doi-asserted-by":"crossref","first-page":"1819","DOI":"10.1002\/art.1780381215","article-title":"Risk factors for septic arthritis in patients with joint disease. A prospective study","volume":"38","author":"C J Kaandorp","year":"1995","journal-title":"Arthritis Rheum"},{"issue":"10","key":"ref10","doi-asserted-by":"crossref","first-page":"480","DOI":"10.4103\/1947-2714.168678","article-title":"Septic arthritis in the temporomandibular joint","volume":"7","author":"H M Al-Khalisy","year":"2015","journal-title":"N Am J Med Sci"},{"issue":"03","key":"ref11","doi-asserted-by":"crossref","first-page":"ofae091","DOI":"10.1093\/ofid\/ofae091","article-title":"Septic arthritis of the spinal facet joint: review of 117 cases","volume":"11","author":"J J Ross","year":"2024","journal-title":"Open Forum Infect Dis"},{"issue":"307","key":"ref12","first-page":"174","article-title":"Staged arthrodesis for salvage of the septic hallux metatarsophalangeal joint","author":"M S Myerson","year":"1994","journal-title":"Clin Orthop Relat Res"},{"issue":"07","key":"ref13","doi-asserted-by":"crossref","first-page":"596","DOI":"10.3390\/antibiotics13070596","article-title":"Native joint septic arthritis","volume":"13","author":"K A Wu","year":"2024","journal-title":"Antibiotics (Basel)"},{"issue":"02","key":"ref14","doi-asserted-by":"crossref","first-page":"2309499019860468","DOI":"10.1177\/2309499019860468","article-title":"The difference between native septic arthritis and prosthetic joint infections: a review of literature","volume":"27","author":"R L Roerdink","year":"2019","journal-title":"J Orthop Surg (Hong Kong)"},{"issue":"02","key":"ref15","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1097\/BPO.0000000000000411","article-title":"The clinical usefulness of polymerase chain reaction as a supplemental diagnostic tool in the evaluation and the treatment of children with septic arthritis","volume":"36","author":"K Carter","year":"2016","journal-title":"J Pediatr Orthop"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"S325","DOI":"10.1016\/j.arth.2018.09.045","article-title":"Hip and knee section, What is the definition of a periprosthetic joint infection (PJI) of the knee and the hip? Can the same criteria be used for both joints? Proceedings of International Consensus on Orthopedic Infections","volume":"34","author":"N Shohat","year":"2019","journal-title":"J Arthroplasty"},{"issue":"12","key":"ref17","doi-asserted-by":"crossref","first-page":"1662","DOI":"10.2106\/00004623-199912000-00002","article-title":"Differentiating between septic arthritis and transient synovitis of the hip in children: an evidence-based clinical prediction algorithm","volume":"81","author":"M S Kocher","year":"1999","journal-title":"J Bone Joint Surg Am"},{"issue":"03","key":"ref18","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1177\/18632521221106383","article-title":"The modified Kocher criteria for septic hip: does it apply to the knee?","volume":"16","author":"R U Bisht","year":"2022","journal-title":"J Child Orthop"},{"issue":"03","key":"ref19","doi-asserted-by":"crossref","first-page":"568","DOI":"10.2214\/AJR.20.22773","article-title":"Septic arthritis: an evidence-based review of diagnosis and image-guided aspiration","volume":"215","author":"B Y Chan","year":"2020","journal-title":"AJR Am J Roentgenol"},{"issue":"02","key":"ref20","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1148\/radiol.2482062110","article-title":"Radiographic evaluation of arthritis: inflammatory conditions","volume":"248","author":"J A Jacobson","year":"2008","journal-title":"Radiology"},{"issue":"02","key":"ref21","doi-asserted-by":"crossref","first-page":"377","DOI":"10.2214\/ajr.163.2.8037035","article-title":"Appearance of septic hip prostheses on plain radiographs","volume":"163","author":"S Tigges","year":"1994","journal-title":"AJR Am J Roentgenol"},{"issue":"05","key":"ref22","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1097\/00005792-199309000-00002","article-title":"Polyarticular septic arthritis","volume":"72","author":"J J Dubost","year":"1993","journal-title":"Medicine (Baltimore)"},{"issue":"21","key":"ref23","doi-asserted-by":"crossref","first-page":"6808","DOI":"10.3390\/jcm12216808","article-title":"Administering antibiotics for less than four weeks increases the risk of relapse in culture-positive septic arthritis of native joints","volume":"12","author":"E J Joo","year":"2023","journal-title":"J Clin Med"},{"issue":"01","key":"ref24","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13075-019-2050-4","article-title":"The importance of ultrasound in identifying and differentiating patients with early inflammatory arthritis: a narrative review","volume":"22","author":"G S Kaeley","year":"2020","journal-title":"Arthritis Res Ther"},{"issue":"03","key":"ref25","doi-asserted-by":"crossref","first-page":"W453","DOI":"10.2214\/AJR.12.9177","article-title":"Value of ultrasound before joint aspiration","volume":"201","author":"T A Hadduck","year":"2013","journal-title":"AJR Am J Roentgenol"},{"issue":"06","key":"ref26","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1002\/pmrj.12873","article-title":"Comparing fluoroscopic versus ultrasound guidance in glenohumeral joint aspiration","volume":"15","author":"J Provo","year":"2023","journal-title":"PM R"},{"issue":"01","key":"ref27","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1007\/s11547-017-0811-1","article-title":"Fluoroscopy- vs ultrasound-guided aspiration techniques in the management of periprosthetic joint infection: which is the best?","volume":"123","author":"F Randelli","year":"2018","journal-title":"Radiol Med"},{"issue":"04","key":"ref28","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1002\/emp2.12167","article-title":"Point-of-care hip ultrasound leads to expedited results in emergency department patients with suspected septic arthritis","volume":"1","author":"C Thom","year":"2020","journal-title":"J Am Coll Emerg Physicians Open"},{"issue":"S 01","key":"ref29","doi-asserted-by":"crossref","first-page":"S101","DOI":"10.1007\/s00256-006-0194-1","article-title":"Extra-osseous fat fluid level: a specific sign for osteomyelitis","volume":"36","author":"J Kumar","year":"2007","journal-title":"Skeletal Radiol"},{"issue":"06","key":"ref30","doi-asserted-by":"crossref","first-page":"1289","DOI":"10.2214\/AJR.14.12891","article-title":"Septic arthritis in children: frequency of coexisting unsuspected osteomyelitis and implications on imaging work-up and management","volume":"204","author":"J Monsalve","year":"2015","journal-title":"AJR Am J Roentgenol"},{"key":"ref31","first-page":"515","article-title":"Musculoskeletal infections in children: basic treatment principles and recent advancements","volume":"54","author":"J J McCarthy","year":"2005","journal-title":"Instr Course Lect"},{"issue":"07","key":"ref32","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1302\/2058-5241.6.200155","article-title":"Acute osteoarticular infections in children are frequently forgotten multidiscipline emergencies: beyond the technical skills","volume":"6","author":"T El-Sobky","year":"2021","journal-title":"EFORT Open Rev"},{"issue":"02","key":"ref33","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1055\/s-0029-1214160","article-title":"Radiographic imaging in osteomyelitis: the role of plain radiography, computed tomography, ultrasonography, magnetic resonance imaging, and scintigraphy","volume":"23","author":"C Pineda","year":"2009","journal-title":"Semin Plast Surg"},{"issue":"11","key":"ref34","first-page":"2464","article-title":"The accuracy of diagnostic imaging for the assessment of chronic osteomyelitis: a systematic review and meta-analysis","volume":"87","author":"M F Termaat","year":"2005","journal-title":"J Bone Joint Surg Am"},{"issue":"05","key":"ref35","doi-asserted-by":"crossref","first-page":"1182","DOI":"10.2214\/AJR.09.4082","article-title":"Treatment of deep intramuscular and musculoskeletal abscess: experience with 99 CT-guided percutaneous catheter drainage procedures","volume":"196","author":"C G Cronin","year":"2011","journal-title":"AJR Am J Roentgenol"},{"issue":"02","key":"ref36","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1016\/j.radcr.2016.02.014","article-title":"Synovial cutaneous fistula complicating a reverse total shoulder arthroplasty","volume":"11","author":"H P Letter","year":"2016","journal-title":"Radiol Case Rep"},{"key":"ref37","doi-asserted-by":"crossref","first-page":"253","DOI":"10.2147\/IJNRD.S371700","article-title":"Contrast-induced acute kidney injury: evidence in support of its existence and a review of its pathogenesis and management","volume":"15","author":"H Chaudhari","year":"2022","journal-title":"Int J Nephrol Renovasc Dis"},{"issue":"06","key":"ref38","doi-asserted-by":"crossref","first-page":"539","DOI":"10.3390\/ijerph13060539","article-title":"A case of acute osteomyelitis: an update on diagnosis and treatment","volume":"13","author":"E Chiappini","year":"2016","journal-title":"Int J Environ Res Public Health"},{"issue":"08","key":"ref39","doi-asserted-by":"crossref","first-page":"530","DOI":"10.4329\/wjr.v6.i8.530","article-title":"Role of MRI in the diagnosis and treatment of osteomyelitis in pediatric patients","volume":"6","author":"B S Pugmire","year":"2014","journal-title":"World J Radiol"},{"issue":"02","key":"ref40","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1148\/radiol.2019191116","article-title":"Trends in diagnostic imaging utilization among Medicare and commercially insured adults from 2003 through 2016","volume":"294","author":"A S Hong","year":"2020","journal-title":"Radiology"},{"issue":"04","key":"ref41","doi-asserted-by":"crossref","first-page":"703","DOI":"10.3390\/diagnostics13040703","article-title":"Osteomyelitis of the lower limb: diagnostic accuracy of dual-energy CT versus MRI","volume":"13","author":"G Foti","year":"2023","journal-title":"Diagnostics (Basel)"},{"issue":"06","key":"ref42","first-page":"495","article-title":"Magnetic resonance imaging of osteomyelitis","volume":"33","author":"J Tehranzadeh","year":"1992","journal-title":"Crit Rev Diagn Imaging"},{"issue":"01","key":"ref43","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1148\/radiol.2020191901","article-title":"Diagnosis of periprosthetic hip joint infection using MRI with metal artifact reduction at 1.5 T","volume":"296","author":"J Galley","year":"2020","journal-title":"Radiology"},{"issue":"08","key":"ref44","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1097\/RLI.0000000000000866","article-title":"New-generation low-field magnetic resonance imaging of hip arthroplasty implants using slice encoding for metal artifact correction: first in vitro experience at 0.55 T and comparison with 1.5 T","volume":"57","author":"I Khodarahmi","year":"2022","journal-title":"Invest Radiol"},{"issue":"01","key":"ref45","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1097\/BPO.0000000000000389","article-title":"Predicting the presence of adjacent infections in septic arthritis in children","volume":"36","author":"S Rosenfeld","year":"2016","journal-title":"J Pediatr Orthop"},{"issue":"05","key":"ref46","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1097\/BPO.0000000000000934","article-title":"Predicting periarticular infection in children with septic arthritis of the hip: regionally derived criteria may not apply to all populations","volume":"39","author":"C A Refakis","year":"2019","journal-title":"J Pediatr Orthop"},{"issue":"05","key":"ref47","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1007\/BF00197059","article-title":"Gadolinium-DTPA-enhanced magnetic resonance imaging of musculoskeletal infectious processes","volume":"24","author":"K L Hopkins","year":"1995","journal-title":"Skeletal Radiol"},{"issue":"01","key":"ref48","doi-asserted-by":"crossref","first-page":"119","DOI":"10.2214\/ajr.182.1.1820119","article-title":"MRI findings of septic arthritis and associated osteomyelitis in adults","volume":"182","author":"M Karchevsky","year":"2004","journal-title":"AJR Am J Roentgenol"},{"issue":"10","key":"ref49","doi-asserted-by":"crossref","first-page":"5682","DOI":"10.1007\/s00330-019-06143-6","article-title":"Evaluation of suspected musculoskeletal infection in children over 2 years of age using only fluid-sensitive sequences at MRI","volume":"29","author":"B K Markhardt","year":"2019","journal-title":"Eur Radiol"},{"issue":"01","key":"ref50","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1007\/s00247-018-4256-z","article-title":"Detection of pediatric musculoskeletal pathology using the fluid-sensitive sequence","volume":"49","author":"J C Nguyen","year":"2019","journal-title":"Pediatr Radiol"},{"issue":"01","key":"ref51","doi-asserted-by":"crossref","first-page":"83","DOI":"10.4103\/jwas.jwas_83_23","article-title":"Role of magnetic resonance imaging in concomitant periarticular infections in septic arthritis of large joints in children: a systematic review","volume":"14","author":"V Garg","year":"2024","journal-title":"J West Afr Coll Surg"},{"issue":"05","key":"ref52","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1177\/18632521221126922","article-title":"Magnetic resonance imaging in the evaluation of suspected hip sepsis in children","volume":"16","author":"N Corin","year":"2022","journal-title":"J Child Orthop"},{"issue":"02","key":"ref53","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1097\/BPO.0000000000001113","article-title":"The introduction of a preoperative MRI protocol significantly reduces unplanned return to the operating room in the treatment of pediatric osteoarticular infections","volume":"40","author":"B G Griswold","year":"2020","journal-title":"J Pediatr Orthop"},{"issue":"03","key":"ref54","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1097\/BPO.0000000000000097","article-title":"Improving diagnostic efficiency: analysis of pelvic MRI versus emergency hip aspiration for suspected hip sepsis","volume":"34","author":"H P Gottschalk","year":"2014","journal-title":"J Pediatr Orthop"},{"issue":"01","key":"ref55","doi-asserted-by":"crossref","first-page":"nihpa116823","DOI":"10.3810\/psm.2008.12.11","article-title":"Osteomyelitis: approach to diagnosis and treatment","volume":"36","author":"J M Fritz","year":"2008","journal-title":"Phys Sportsmed"},{"issue":"03","key":"ref56","first-page":"167","article-title":"Nuclear medicine methods for evaluation of skeletal infection among other diagnostic modalities","volume":"50","author":"T A El-Maghraby","year":"2006","journal-title":"Q J Nucl Med Mol Imaging"},{"issue":"03","key":"ref57","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1148\/rg.263055139","article-title":"Combined labeled leukocyte and technetium 99m sulfur colloid bone marrow imaging for diagnosing musculoskeletal infection","volume":"26","author":"C J Palestro","year":"2006","journal-title":"Radiographics"},{"issue":"05","key":"ref58","doi-asserted-by":"crossref","first-page":"640","DOI":"10.1080\/17453670710014338","article-title":"White blood cell scintigraphy for differentiation of infection and aseptic loosening: a retrospective study of 76 painful hip prostheses","volume":"78","author":"L Simonsen","year":"2007","journal-title":"Acta Orthop"},{"issue":"03","key":"ref59","doi-asserted-by":"crossref","first-page":"732","DOI":"10.1148\/radiol.2452061877","article-title":"Osteomyelitis: antigranulocyte scintigraphy with 99mTC radiolabeled monoclonal antibodies for diagnosis\u2013meta-analysis","volume":"245","author":"E E Pakos","year":"2007","journal-title":"Radiology"},{"issue":"02","key":"ref60","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/j.cpet.2019.11.005","article-title":"18F-FDG PET for diagnosing infections in prosthetic joints","volume":"15","author":"R M Kwee","year":"2020","journal-title":"PET Clin"},{"issue":"06","key":"ref61","doi-asserted-by":"crossref","first-page":"1197","DOI":"10.1016\/j.berh.2006.08.009","article-title":"Infection and musculoskeletal conditions: Imaging of musculoskeletal infections","volume":"20","author":"C J Palestro","year":"2006","journal-title":"Best Pract Res Clin Rheumatol"},{"issue":"03","key":"ref62","first-page":"339","article-title":"Indium-111 leukocyte imaging in patients with rheumatoid arthritis","volume":"27","author":"K Uno","year":"1986","journal-title":"J Nucl Med"},{"issue":"05","key":"ref63","first-page":"682","article-title":"Appearance of acute gouty arthritis on indium-111-labeled leukocyte scintigraphy","volume":"31","author":"C J Palestro","year":"1990","journal-title":"J Nucl Med"},{"issue":"02","key":"ref65","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1089\/sur.2007.036","article-title":"Local anesthetics as antimicrobial agents: a review","volume":"9","author":"S M Johnson","year":"2008","journal-title":"Surg Infect (Larchmt)"},{"key":"ref66","doi-asserted-by":"crossref","first-page":"S339","DOI":"10.1016\/j.arth.2018.09.018","article-title":"Hip and knee section, Diagnosis, algorithm. Proceedings of International Consensus on Orthopedic Infections","volume":"34","author":"M Abdel Karim","year":"2019","journal-title":"J Arthroplasty"}],"container-title":["Seminars in Musculoskeletal Radiology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0045-1802352.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,31]],"date-time":"2025-03-31T23:11:31Z","timestamp":1743462691000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0045-1802352"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,31]]},"references-count":65,"journal-issue":{"issue":"02","published-online":{"date-parts":[[2025,3,31]]},"published-print":{"date-parts":[[2025,4]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0045-1802352","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["1089-7860","1098-898X"],"issn-type":[{"value":"1089-7860","type":"print"},{"value":"1098-898X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,31]]}}}