Age and gender are also aids to diagnosis. Although no clinical pattern is diagnostic, certain general observations are helpful. Septic arthritis is important in infants and children,3 with typical affecting organisms characteristic of age and development (I§ble,2Z.8-4). Additionally, a number of infectious and inflammatory processes are unique to childhood (TabJe^ZS-S).3 In teen and adult years, sexual activity results in an increase in prevalence of gonococcal arthritis and Reiter syndrome associated with chlamydial urethritis.4
TABLE 278-4 Commonly Encountered Organisms in the Septic Arthritis Patient
Crystal-induced arthritides commonly affect middle-aged adults. Gout is the commonest inflammatory joint disease in men over age 40. 5 The classic gout patient is a middle-aged man with an acute monoarthritis. Women, however, are generally spared the onset of gout until later middle age and can develop polyarticular involvement.5
As age progresses, the incidence of rheumatoid and osteoarthritis increases. Whereas osteoarthritis is a disease of older adults (over age 60), rheumatoid arthritis tends to strike earlier with a predilection for women three to four times that of men.1 Additionally, rheumatoid arthritis classically demonstrates a progressive course with additive, polyarticular involvement of symmetric joints.6
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