2.2. Diagnosis
Septic arthritis is often particularly challenging to diagnose after
arthroscopy, as the clinical symptoms may resemble those oftenproduced by the procedure itself in the absence of complications.
Thedefinitediagnosis relies onidentificationof anorganismindeep
specimens. Consequently, emergent joint aspiration is in order,
followed by microscopic examination of smears and prolonged cultures
on specific media. Nevertheless, negative results from these
microbiological tests do not completely rule out a deep infection.
This situation requires close monitoring and, if appropriate, either a
second joint aspiration or arthroscopy to allow joint lavage and the
intraoperative collection of multiple deep specimens [6]. The main
mistake at this stage is to forego the establishment of a definite
diagnosis, instead initiating empirical antibiotic therapy, which
may prevent the recovery of a causative organism from all future
specimens while allowing a smouldering infection to cause gradual
joint damage.