We live in a small town with only a rural clinic and 15-bed hospital to serve our needs. We love our nurse practioner and emergency physician. But our daughter has been hospitalized for a septic knee. So we are just checking to see if the treatment she is getting is standard or if we should consider moving her to the nearest large medical center (150 miles away).

Bacterial arthritis (also called septic or infectious arthritis) causes a local response with joint destruction and infection. Bacteria, viruses, and fungi are all capable of infecting a joint, by invading and inflaming the synovial membrane.

Staphylococcus aureus and Kingella Kingae, and streptococcus pneumoniae are the most common organisms responsible for infectious arthritis in children.

Damage to the joint with possible permanent results is a concern with this diagnosis. The longer the wait from onset to treatment, the greater the risk for a poor outcome. Early treatment with IV (intravenous) antibiotics is the standard line of care.

Sometimes a broad spectrum antibiotic is used until blood tests (or tests of the joint fluid) come back from the lab with the exact microorganism (bacteria) that’s causing the problem. Then an antibiotic more specific to target that bacteria can be used if necessary.

Studies are being done to see if adding a steroid medication to the antibiotics might speed up the healing process without adding any negative side effects. The first experiments were done in mice. Recently, pilot studies with a small number of live patients have been done with promising results.