17 June 2025
With a focus on septic arthritis, this upcoming guideline will replace the previous version from 2006 to provide vital new evidence-based recommendations for the investigation and management of the hot swollen joint (HSJ) in adults. The updated guideline is in development alongside our new clinical guideline for hot, swollen and stiff joints in children and young people, the scope for which was also published earlier this month.
Publication of the scope document for the HSJ guideline update is an important milestone in the guideline’s early development. The scope of the update was informed by a stakeholder survey conducted across our membership and outlines the key issues and clinical questions that the recommendations will address, across five main areas:
- Investigation of a HSJ
- Medical and surgical management of septic arthritis
- Duration of treatment and follow-up
- Outcome measures and goals for treatment
- Patient information and support
The guideline working group (GWG), chaired by Dr Muddassir Shaikh, includes experts from across the whole multi-professional team, including rheumatology, orthopaedic, infectious disease and microbiology specialties as well as a general practitioner and expert patients with lived experience of septic arthritis.
Following the scope publication in Rheumatology Advances in Practice, the evidence review is now underway, led by Prof James Galloway at Kings College London. The GWG will meet later this year to review the collated evidence and develop recommendations using GRADE methodology, as outlined in the BSR Creating Clinical Guidelines Protocol, available here.
The full guideline is expected to be published in the first half of 2026 and we will be welcoming participation in a public consultation of the draft recommendations prior to publication.