Pneumococcal arthritis is a form of acute pus-forming arthritis resulting from complications of bacteria in the blood (bacteremia) from another source. The condition has the characteristics of infectious or septic arthritis.

Pneumococcal arthritis is the result of having a widespread pneumococci infection.

Signs and symptoms include a rapid onset, moderate to severe joint pain, warmth, tenderness, and restricted motion. Chills and fever may be present. There may be no other symptoms of a serious infection. The condition may involve a single joint such as the knee or other common sites that include the hip, shoulder, wrist, and ankle.

Diagnostic measures include blood cultures and analysis of the synovial fluid, and X-rays. X-rays may show bony erosions and narrowing of the joint space followed by osteomyelitis and periostitis after 2 weeks.

Treatment consists of antibiotic therapy, aspiration of the synovial fluid, and measures to relieve the pain, including local warm compresses. Surgical drainage is indicated for all joints that do not respond within 72 hours of antibiotic therapy and aspiration. Arthroscopy of the knee appears to be the best form of surgical treatment when technically feasible. The joint may also be immobilized and elevated.

There may be little or no residuals. Functional recovery is usually good. A painful stiff contracted joint may occur in severe cases particularly with delay in treatment. If the person has sepsis involving many joints (polyarticular), there may be serious respiratory complications.

• The rating schedule for musculoskeletal was updated on February 7, 2021. Protection still does apply and should be considered with existing evaluations (38 CFR 3.951(a)).

• The disease must have become manifest to a degree of 10 percent or more within 1 year (for Hansen's disease (leprosy) and tuberculosis, within 3 years; multiple sclerosis, within 7 years) from the date of separation from service as specified in paragraph (a)(2) of this section. See 38 CFR 3.307(a (3) and §3.309(a) [chronic disease].

• May be entitled to special monthly compensation where the veteran has a single service-connected disability rated as 100% with additional service-connected disability or disabilities independently ratable at 60% or more, which are separate and distinct from the 100% service-connected disability and involves different anatomical segments or bodily systems. See  38 CFR 3.350(i)(1) – Total plus 60% – Special Monthly Compensation (SMC).

• Other specified forms of arthropathy include, but are not limited to, Charcot neuropathic, hypertrophic, crystalline, and other autoimmune arthropathies.

• With the types of arthritis, diagnostic codes 5004 through 5009, rate the acute phase under diagnostic code 5002; rate any chronic residuals under diagnostic code 5003.