Members sought for hot swollen joint guideline update

20 September 2023

Article kindly written by Lindsay Turner, Clinical Guidelines Programme Manager for British Society for Rheumatology.

The British Society for Rheumatology (BSR) published its guideline for the management of the hot swollen joint in adults in 2006. Although BSR guidelines are considered for update after four years, a statement published in 2017 explained that there was a distinct lack of good quality evidence to guide best practice in 2006 and that the evidence base still remained poor.

BSR now plans to conduct a formal review of the guideline, using the rigorous methodology outlined in the clinical guideline protocol, to ascertain the current availability of evidence and provide up-to-date recommendations. Areas still lacking evidence will be highlighted through research recommendations.

The clinical presentation of a hot swollen joint is common and has wide differential diagnosis. The most serious is septic arthritis. The guideline update will focus on the diagnosis and management of septic arthritis, which is key, as delayed or inadequate treatment leads to joint damage. Hot swollen joints commonly have other underlying diagnoses, including crystal arthritis, reactive arthritis and a monoarticular presentation of polyarthritis.

BSR is currently convening the multi-professional working group to develop the guideline update. The group will include experts who have experience of the hot swollen joint, with representatives across primary and secondary care; doctors, nurses, pharmacists, allied health professionals and people with lived experience of the condition.

If you are interested in taking part, enquiries are welcomed via email. Experience in guideline development is desirable but not essential.