Khudair Aiman, Khudair Ahmed, Butler Alexandra E
School of Medicine, Royal College of Surgeons in Ireland - Medical University of Bahrain, Busaiteen, Bahrain.
Research Department, Royal College of Surgeons in Ireland - Medical University of Bahrain, Busaiteen, Bahrain.
Front Med (Lausanne). 2025 Jul 29;12:1566384. doi: 10.3389/fmed.2025.1566384. eCollection 2025.
Septic arthritis (SA) is an orthopedic emergency characterized by joint inflammation secondary to infectious etiologies, most commonly . The prompt recognition of SA is crucial due to its significant morbidity and mortality. Fever, along with a swollen, painful joint and limited range of motion, are typical manifestations; however, presentations can vary. The incidence of SA in adult populations is rising, accompanied by unfavorable mortality rates. This trend is further exacerbated by comorbid conditions that substantially influence outcomes. Among the literature, diabetes mellitus (DM), rheumatoid arthritis (RA), and chronic kidney disease (CKD) have emerged as key prognostic factors in SA. DM exacerbates the severity of SA through impairment of polymorphonuclear function, ultimately leading to increased susceptibility to infection and a higher risk of acquiring infection from atypical pathogens. CKD causes uremia-induced immune dysfunction leading to an immunocompromised state as well as repeated vascular access increasing infection susceptibility, leading to increased mortality. Patients with RA harbor an elevated risk of SA, attributed to immune dysregulation, immunosuppressive therapy, and diagnostic challenges. Additionally, these comorbidities can complicate the surgical management of SA and increase the likelihood of treatment failure. Therefore, given the rising burden of comorbid conditions worldwide and their impact on SA prognosis, healthcare professionals should remain vigilant when managing these factors. A holistic, multidisciplinary approach to management is vital to ensure that SA patients with these certain comorbid conditions experience fewer complications and improved survival. This mini-review aims to highlight the key comorbid conditions that impact the prognosis of SA patients.
脓毒性关节炎（SA）是一种骨科急症，其特征为继发于感染性病因（最常见的是……）的关节炎症。由于SA具有较高的发病率和死亡率，因此及时识别至关重要。发热，以及关节肿胀、疼痛和活动范围受限是典型表现；然而，临床表现可能会有所不同。成人SA的发病率正在上升，同时死亡率也不容乐观。合并症会严重影响治疗结果，进一步加剧了这一趋势。在相关文献中，糖尿病（DM）、类风湿关节炎（RA）和慢性肾脏病（CKD）已成为SA的关键预后因素。DM通过损害多形核白细胞功能加重SA的严重程度，最终导致感染易感性增加以及感染非典型病原体的风险更高。CKD导致尿毒症引起的免疫功能障碍，导致免疫功能低下状态，以及反复的血管通路增加感染易感性，从而导致死亡率增加。RA患者发生SA的风险较高，这归因于免疫失调、免疫抑制治疗和诊断挑战。此外，这些合并症会使SA的手术治疗复杂化，并增加治疗失败的可能性。因此，鉴于全球范围内合并症负担的增加及其对SA预后的影响，医疗保健专业人员在管理这些因素时应保持警惕。采用全面、多学科的管理方法对于确保患有这些特定合并症的SA患者并发症更少、生存率提高至关重要。本综述旨在强调影响SA患者预后的关键合并症。
