MBBS OSCE · General Medicine
OSCE — Septic Arthritis
Eight-minute OSCE station on Septic Arthritis: focused history, examination priorities, investigations, emergency and definitive management.
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Brief (to candidate)
You will assess a patient with a presentation consistent with Septic Arthritis.
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.
Clinical context
Septic arthritis is a medical and surgical emergency — direct microbial invasion of a joint space (usually bacterial and haematogenous) causing purulent synovial inflammation, rapid articular cartilage destruction, sepsis and death if untreated. Incidence is 4 to 10 per 100,000 in the West and rises steeply with prosthetic joints, rheumatoid arthritis, diabetes, immunosuppression, IV drug use and age over 80. The knee is the commonest joint (about half of cases). Staphylococcus aureus is the commonest organism in all ages; Neisseria gonorrhoeae in young sexually active adults (migratory polyarthralgia, tenosynovitis, pustular rash); Group B streptococcus in neonates; Haemophilus influenzae a
Candidate tasks
- Clarify onset, severity, associated features, and red-flag symptoms.
- State focused examination priorities.
- List first-line investigations and any named score/criteria.
- Give immediate resuscitation steps.
- Outline definitive management with doses/routes where standard.
- Name complications and disposition (ward / HDU / theatre / discharge safety-net).
- Mention one special-population modifier (pregnancy, child, elderly, CKD).
Examiner checklist
| Domain | Pass behaviours |
|---|---|
| Definition | Correct working diagnosis language |
| Assessment | Focused, prioritised, red flags sought |
| Investigations | Appropriate first-line + interpretation |
| Emergency care | ABC / time-critical actions first |
| Definitive care | Specific drugs/procedures, not generic phrases |
| Safety | Any acute hot, swollen, tender joint with severe pain on movement - septic arthr |
| Safety | Young sexually active adult with migratory arthralgia, tenosynovitis and pustula |
| Safety | Prosthetic joint with new pain, warmth, effusion or sinus tract - prosthetic joi |
| Communication | Clear plan and safety-netting |
Model outline
Lead with the working diagnosis and life threats. Resuscitate before definitive tests when unstable. Use guideline-standard therapy with named agents and doses. Document escalation criteria and follow-up. A safe candidate is specific, structured, and never delays critical care for non-urgent imaging.