Refractory Ankle Pain: A Case of Septic Arthritis Vignette A 51-year-old male with a history of uncontrolled Type 2 Diabetes presents to the ED with refractory left ankle pain.
Refractory Ankle Pain: A Case of Septic Arthritis Vignette A 51-year-old male with a history of uncontrolled Type 2 Diabetes presents to the ED with refractory left ankle pain. The patient had been evaluated in an urgent care three days prior and discharged with a steroid pack and NSAIDs, however, his pain continued to worsen. His vital signs are stable, however he reports subjective fevers.
On physical exam, his left ankle is warm, swollen, with exquisite tenderness and limited range of motion in all planes. What is the gold standard test for the suspected diagnosis? Medical history and physical exam Septic arthritis is a painful infection involving the joints of the body that may stem from a local penetrating injury (bite, drug injection, prior joint replacement, trauma, etc.) or another infection in the body, such as a urinary tract infection or bacteremia, that spreads through the bloodstream to seed a joint.
While uncommon (2-10 cases per 100,000 per year), the incidence of septic arthritis appears to be increasing, possibly due to an aging population, increased antibiotic resistance, and the use of immunosuppressive agents. Septic arthritis is a must rule out diagnosis, especially when accompanied by cardinal signs of inflammation, including redness (rubor), swelling (tumour), heat (calor), pain (dolor) and loss of function (functio laesa). The ankle (8.6%) is the fourth most involved joint in septic arthritis, following the knee (45.7%), hip (31.4%), and shoulder (11.4%). If left untreated or treatment is delayed, septic arthritis can lead to joint degeneration and permanent damage.
If you are experiencing symptoms that may be related to a case of septic arthritis, it is important to see a sports medicine physician. Early evaluation and treatment typically lead to better outcomes. Do not ignore pain or symptoms that are limiting your activity.
*This article is for educational purposes only and does not substitute for professional medical advice. Always consult a qualified healthcare provider.*
Connect with a doctor, physical therapist, or imaging center near you.
Find a Provider Near You โ