Septic arthritis is an acute bacterial infection of one or more native joints. Clinical outcomes are poor with about 40-50% suffering long-term sequelae. Pro-inflammatory cytokine levels in the joint correlate negatively with patients’ quality of life and the level of osteoarthritis at 1-year.
Current clinical management addresses the underlying causal pathology (surgical and antibiotic treatment of the infection), but not the associated joint inflammation. There is some evidence supporting the use of corticosteroids for children with septic arthritis, but most cases in the UK occur in adults. A recent journal article suggested doctors treating septic arthritis should consider using corticosteroids, even without the required research evidence-base.
We propose research to investigate the addition of systemic corticosteroids (intravenous or oral) to existing UK standard of care (joint drainage and at least 4 weeks of antibiotics) in acute bacterial native, large-joint septic arthritis and would be very interested, and grateful, for your answers to the questions below (it will take about 5 minutes or less):