Computed tomography of septic joints

      This paper is only available as a PDF. To read, Please Download here.


      Twenty-six patients with suspected or known septic joints who had been studied by computed tomography were retrospectively reviewed. Eighteen patients (20 joints) proved to have septic arthritis. Computed tomography was advantageous in patients with acute septic arthritis of deep-seated axial joints, such as the hip and sacroiliac, where it demonstrated periarticular soft tissue swelling as early as 36 hours after the onset of symptoms. In three patients, this finding on computed tomography was helpful in accurately localizing the disease process and facilitating a diagnostic closed needle aspiration biopsy procedure. Four patients had a primary osseous focus of infection in an adjacent epiphyseal region that was documented by computed tomography. Computed tomography was superior to conventional radiology in revealing early articular bone erosion in joints with curved and overlapping articular surfaces in five patients, and resulted in alteration of their treatment. Fat-fluid levels within the suprapatellar bursae were noted in one patient (two joints). Computed tomography is a valuable modality for evaluation of patients with suspected septic arthritis of axial joints, particularly in the acute stage. Furthermore, it is helpful for evaluation of possible periarticular abscess formation and can serve as a guide for a percutaneous drainage procedure. Computed tomography can also be used when articular bone erosion or medullary extension of osteomyelitis is suspected but not fully documented by conventional radiography.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Clinical Imaging
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Butt W.P.
        Radiology of infected joint.
        Clin Orthop Relat Res. 1973; 96: 136-149
        • Kelly P.J.
        • Martin W.J.
        • Coventry M.B.
        Bacterial (suppurative) arthritis in the adult.
        J Bone Joint Surg. 1970; 52-A: 1595-1602
        • Willerson J.T.
        • Barth W.F.
        • Decker J.L.
        Septic arthritis, the unexpected complication.
        Post Grad Med. 1969; 45: 127-128
        • Ward J.R.
        • Atcheson S.G.
        Infectious arthritis.
        Med Clin North Am. 1977; 61: 313-329
        • Meredith H.C.
        • Rittenberg G.M.
        Pneumoarthropathy: An unusual radiographic sign of gram-negative septic arthritis.
        Radiology. 1978; 129: 624
        • Lisbona R.
        • Rosenthal L.
        Observations on the sequential use of 99mTc-phosphate complex and GA67 imaging in osteomyelitis, cellulitis and septic arthritis.
        Radiology. 1977; 123: 123-129
        • Lisbona R.
        • Rosenthal L.
        Radionuclide imaging of septic joints and their differentiation from periarticular osteomyelitis and cellulitis in pediatrics.
        Clin Nucl Med. 1977; 2: 337-342
        • Azouz E.M.
        Computed tomography in bone and joint infections.
        J Can Assoc Radiol. 1981; 32: 102-106
        • Destouet J.M.
        • Gilula L.A.
        • Murphy W.A.
        • et al.
        Computed tomography of the sternoclavicular joint and sternum.
        Radiology. 1981; 138: 123-128
        • Firooznia H.
        • Golimbu C.
        • Rafii M.
        • et al.
        Computed tomography of the sacroiliac joints: Comparison with complex motion tomography.
        J Comput Assist Tomogr. 1984; 8: 31-39
        • Newman J.H.
        Review of septic arthritis throughout the antibiotic era.
        Ann Rheum Dis. 1976; 35: 198-205
        • Gordon G.
        • Kabins S.A.
        Pyogenic sacroiliitis.
        Am J Med. 1980; 69: 50-56
        • Waldvogel F.A.
        • Medoff G.
        • Swartz M.N.
        Osteomyelitis: A review of clinical features, therapeutic considerations and unusual aspects.
        N Engl J Med. 1970; 282: 198-206
        • Butt W.P.
        The radiology of infection.
        Clin Orthop Rel Res. 1973; 96: 20-30