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Septic Arthritis in Pregnancy: The Great Imitator

Background: In light of increasing intravenous drug use in reproductive age women, it is important to create a high index of suspicion for septic arthritis (SA) in the antepartum population.

Cases: Patient 1 presented after a fall and was thought to have avascular necrosis. Patient 2 presented with lower extremity pain and weakness and was treated with steroids. Patient 3 presented with and was treated for pyelonephritis. All women reported a history of intravenous drug use. Two of the three women were afebrile with normal white blood cell count, whereas the third presented acutely septic. Each patient was ultimately diagnosed with SA.

Conclusion: If there is even a remote history of intravenous drug use, one must consider SA in the differential diagnosis of back and extremity pain.


Emily J Gregory, Kimberly B Fortner, Tina Dudney and Lynlee M Wolfe

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