Joint Aspiration for the Diagnosis of Suspected Native Septic Arthritis

Synovial Gram stain and culture is still the preferred diagnostic test when it comes to accurately diagnosing native joint SA. However, while culture results are pending, a high index of suspicion for SA can be based on a combination of patient's clinical presentation, such as history of fever, previous SA, being IVDU, and a high synovial WCC. These diagnostic aids can help in guiding immediate and targeted antimicrobial therapy, and informing clinical decisions on the need for emergency surgical washout of the joint in the acute setting.