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Peer-reviewedCC BYClinical infectious diseases : an official publication of the Infectious Diseases Society of America

State-of-the-Art Review: Native Joint Septic Arthritis Epidemiology, Pathogenesis, Microbiology, Diagnosis, Management, and Outcomes.

  • Ryan B Khodadadi1
  • Takahiro Matsuo2
  • Kaitlyn C Reasoner1
  • Lauren Nicholas Herrera1
  • Ceylan Colak3
  • Katie D White1
  • Brandon J Yuan4
  • Aaron J Tande5
5 affiliations
  1. 1Division of Infectious Diseases, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
  2. 2Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
  3. 3Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA.
  4. 4Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
  5. 5Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, Minnesota, USA.
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Abstract

Native joint septic arthritis (NJSA) is a time-sensitive orthopedic and infectious diseases emergency associated with substantial morbidity, mortality, and long-term functional impairment. This State-of-the-Art Review synthesizes current evidence on NJSA epidemiology with a primary focus on bacterial etiologies, risk factors, pathogenesis, microbiology, clinical presentation, and diagnostic challenges, including the absence of validated diagnostic criteria and limitations of culture-based evaluation. We summarize current diagnostic approaches with a focus on synovial fluid interpretation and the expanding role of molecular diagnostics. Management principles emphasize timely surgical source control, appropriate antimicrobial therapy, and coordinated multidisciplinary care. Outcomes are reviewed through the lens of relapse, reinfection, and functional recovery, highlighting the influence of host factors, joint involvement, and timeliness of intervention. Finally, we identify persistent gaps in evidence including optimal surgical timing, treatment duration, oral transition, clinical utility of emerging diagnostics, and outline research priorities to improve NJSA care and outcomes.

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Cite

BibTeXRIS
BibTeX
@article{khodadadi2026stateoftheart,
  title = {{State-of-the-Art Review: Native Joint Septic Arthritis Epidemiology, Pathogenesis, Microbiology, Diagnosis, Management, and Outcomes.}},
  author = {Ryan B Khodadadi and Takahiro Matsuo and Kaitlyn C Reasoner and Lauren Nicholas Herrera and Ceylan Colak and Katie D White and Brandon J Yuan and Aaron J Tande},
  journal = {Clinical infectious diseases : an official publication of the Infectious Diseases Society of America},
  year = {2026},
  month = oct,
  doi = {10.1093/cid/ciag473},
  url = {https://europepmc.org/article/MED/42950136},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - State-of-the-Art Review: Native Joint Septic Arthritis Epidemiology, Pathogenesis, Microbiology, Diagnosis, Management, and Outcomes.
AU  - Ryan B Khodadadi
AU  - Takahiro Matsuo
AU  - Kaitlyn C Reasoner
AU  - Lauren Nicholas Herrera
AU  - Ceylan Colak
AU  - Katie D White
AU  - Brandon J Yuan
AU  - Aaron J Tande
PY  - 2026
DA  - 2026/10/01
JO  - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
DO  - 10.1093/cid/ciag473
UR  - https://europepmc.org/article/MED/42950136
AB  - Native joint septic arthritis (NJSA) is a time-sensitive orthopedic and infectious diseases emergency associated with substantial morbidity, mortality, and long-term functional impairment. This State-of-the-Art Review synthesizes current evidence on NJSA epidemiology with a primary focus on bacterial etiologies, risk factors, pathogenesis, microbiology, clinical presentation, and diagnostic challenges, including the absence of validated diagnostic criteria and limitations of culture-based evaluation. We summarize current diagnostic approaches with a focus on synovial fluid interpretation and the expanding role of molecular diagnostics. Management principles emphasize timely surgical source control, appropriate antimicrobial therapy, and coordinated multidisciplinary care. Outcomes are reviewed through the lens of relapse, reinfection, and functional recovery, highlighting the influence of host factors, joint involvement, and timeliness of intervention. Finally, we identify persistent gaps in evidence including optimal surgical timing, treatment duration, oral transition, clinical utility of emerging diagnostics, and outline research priorities to improve NJSA care and outcomes.
SN  - 1058-4838
SN  - 1537-6591
ER  -