Joint Sepsis: A Chance for Cure

Most types of joint inflammation can be controlled with empirical therapies, but only in septic joint inflammation is there an opportunity for cure. The retrospective analysis of 32 culture-proved cases of hematogenous septic arthritis in men by Ho and Su in this issue ofThe Journal(p 797) shows a strong direct correlation between duration of symptoms before treatment and the time needed to sterilize the joint fluid after treatment has begun. Time to sterilize the fluid correlated exceedingly well with treatment outcome, whereas the duration of symptoms did not. These findings are similar to those reported in a prospective study of septic bursitis by the same authors. It is generally accepted that the outcome of joint infection in a previously healthy person will be good if appropriate therapy is given within one week from the onset of symptoms. Delay in treatment beyond one week or the presence of serious