Important aspects in the association of Rheumatoid Arthritis and septic joints
Previously damaged joints and the use of immunosuppressive agents are probably responsible for the increased risk (≤3%) of septic arthritis in patients with RA. The incidence may be increasing with the use of biologic therapy (e.g., anti-tumor necrosis factor agents, others).
The patients are usually those with long-standing seropositive disease, marked disability, and a history of corticosteroid use. Unfortunately, the steroids may blunt the typical symptoms of septic arthritis, causing it to be mistaken for a “flare” of RA. Gram-positive organisms, especially S. aureus , account for 75% to 90% of infections. Rare organisms and polymicrobial infections have also been reported. The most important feature is the poor prognosis.