Early Dermatologic Manifestations of Periprosthetic Joint Infections and Diagnostic Significance: A Literature Review

¹Edward Via College of Osteopathic Medicine, Blacksburg, USA

²Valley Consortium for Medical Education, Modesto, USA

³Philadelphia College of Osteopathic Medicine, Philadelphia, USA

⁴Des Moines University College of Osteopathic Medicine, West Des Moines, USA

⁵A.T. Still University School of Osteopathic Medicine, Arizona, Mesa, USA

⁶Marian University Wood College of Osteopathic Medicine, Indianapolis, USA

⁷Arizona College of Osteopathic Medicine, Glendale, USA

⁸Orlando College of Osteopathic Medicine, Orlando, USA

⁹Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA

¹⁰Department of Dermatology, Northwell Health, New Hyde Park, NY, USA

*Corresponding author: Kelly Frasier, DO, MS, Department of Dermatology, Northwell Health, New Hyde Park, NY, USA, Phone: 3105956882, Email: [email protected]

Received Date: June 27, 2025

Publication Date: August 11, 2025

Citation: Steiss S, et al. (2025). Early Dermatologic Manifestations of Periprosthetic Joint Infections and Diagnostic Significance: A Literature Review. Dermis. 5(4):43.

Copyright: Steiss S, et al. © (2025).

ABSTRACT

Periprosthetic joint infections (PJIs), also known as prosthetic joint infections, are a complex orthopedic complication, with significant costs to the patient and healthcare system. The Musculoskeletal Infection Society (MSIS) updated criteria provides an organized method to help orthopedic surgeons with their diagnostic evaluation of PJIs. However, a periprosthetic joint infection (PJI) presentation can be insidious with non-specific symptoms or emulate other forms of infections, such as cellulitis. Dermatologic signs can be an initial clue of an underlying PJI, such as increased erythema and swelling of the affected joint, which can present acutely or chronically, with variability in severity and presentation. Early PJIs often manifest with joint pain and impaired wound healing, while chronic cases primarily present as persistent pain, and can mimic noninfectious etiologies like aseptic loosening of components. Recent advancements are improving diagnostic accuracy and expediting treatment. However, more precise screening criteria and novel detection strategies, particularly in examination of dermatologic signs, are necessary to improve early diagnosis of a PJI and enhance patient outcomes. This review explores the diagnostic challenges in recognizing dermatologic signs of PJIs, their role in diagnosis, and future directions for improved diagnosis and outcomes.

Keywords: Periprosthetic Joint Infection, Arthroplasty, Orthopedic Surgery, Dermatology, Surgical Infection