A swollen joint: why all the fuss?

Acute arthritis may be a potential medical emergency. An infected joint causes rapid cartilaginous destruction and risk of future osteoarthritis. Prompt attention to the historical clues and potential causative organisms ensures appropriate therapy. Numerous microbes have been identified as the causative agent in septic arthritis, and various populations have distinct susceptibilities to these specific organisms. One broad classification of septic arthritis is differentiating gonococcal and nongonococcal organisms. This classification is important, as not only do the organisms differ, but the age of the patient and the portal of entry also differ. Aspiration of synovial fluid is paramount for proper diagnosis and management of septic arthritis. In addition, the timely administration of properly chosen antibiotic agents is essential for reducing morbidity and mortality.

Definitely hip, but not trendy.

The etiology of hip discomfort and tendinitis often is confusing and the differential diagnosis is large. Some entities are overlooked because diagnosis requires appropriate clinical awareness and a specific radiographic examination. Coxa saltans, or snapping hip, is one of those commonly overlooked diagnoses. There are three types of snapping hip--the internal type, the external type, and the intra-articular type--and each presentation is unique. Most are symptomatic, but some may be quite painful and disabling. Evaluating the hip structures with bursography under dynamic conditions often is helpful to evaluate the anatomy and determine the etiology of the snapping hip. Treatment may range from conservative physical therapy, to corticosteroid injections, to arthroscopic treatment.