Which sign suggests septic arthritis over crystal arthropathy?

• A. Acute onset with fever and marked warmth and significant pain
• B. Chronic joint swelling
• C. Night pain with sleep disturbance
• D. Intermittent joint stiffness

Answer: (A)

Fever with acute onset, marked warmth, and significant joint pain points most strongly to a septic arthritis. This combination reflects an infectious process in the joint, which typically causes a hot, swollen joint with intense pain and often systemic symptoms that make a patient look unwell. Septic arthritis demands urgent evaluation with joint aspiration to analyze synovial fluid and culture, followed by antibiotics and drainage to prevent rapid joint damage. Crystal arthropathy can cause sudden, painful swelling as well, but fever and systemic toxicity are usually less prominent, making the presence of fever a key clue that infection is involved rather than crystal crystals alone.