Streptococcic arthritis is a focal form of disseminated streptococcal infection with bacteremia.

The causes of Streptococcic arthritis are Group B beta-hemolytic streptococci or S. agalactiae, and Group C and G, beta-hemolytic streptococci (S. pyogenes).

The condition usually involves major joints such as: the knee, hip, shoulder, wrist, ankle or elbow. The condition appears in persons with an underlying chronic arthritis such as osteoarthritis (see Diagnostic Code: 5003 Arthritis, degenerative, other than post-traumatic). The signs and symptoms of Streptococcic arthritis include: pain relieved by rest; morning stiffness which is brief and later develops into pain on motion; reduced joint mobility; flexion contracture; tenderness; crepitus; joint enlargement; deformity; and incomplete or partial dislocation of a joint. Rheumatic fever arthritis (see Diagnostic Code: 6309 Rheumatic fever) may occur several weeks after a streptococcal infection and is considered to be a hypersensitivity reaction in joints. (see Diagnostic Code: 5003 Arthritis, degenerative, other than post-traumatic)

A complete blood count (CBC) is done, including bacterial blood cultures to detect the presence of the organism. Analysis of the synovial fluid from an infected joint is carried out. X-rays are used in the diagnosis after 10 to 14 days of the bacterial infection. The results may show destructive changes of joint-space narrowing and erosion, or osteomyelitis that occurs under the cartilage. Bone scans are also done.

Treatment of the condition includes: antibiotics; rehabilitation; nonsteroidal anti-inflammatory drugs (NSAIDs); muscle relaxants; corticosteroids; analgesics; antidepressants and in some cases surgery to remove the accumulation of fluid. Treatment of streptococcal arthritis also includes supportive measures and exercise, balanced with rest, heat, weight reduction and education.

Residuals depend on the severity of the disease or injury, the timeliness and effectiveness of treatments, and the individual's body response to the disease and treatments. Based on the severity of the symptoms, activities may be limited. Residuals can vary from zero disability to total disability, e.g., complete fixation of a joint.

• 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)  – 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.