If untreated, the bacteria causes destruction of the lining cartilage of the bones forming the joint, with eventual destruction of the joint. Tom Smith Arthritis is a form of septic arthritis of the hip joint in infants which destroys the whole head of the femur, being still completely cartilaginous at that age. Usually the presentation is acute pain and high fever. The child is often very sick-looking. The pain is very acute, and the child will not move the joint at all.
Diagnosis is made clinically, with the help of blood tests and imaging techniques.
A blood count reveals very high white blood cell count, with elevated sedimentation rate and C-reactive protein. The latter two tests indicate the level of acute inflammation in the body. Blood cultures may help to identify the responsible organism. X-rays are usually normal in the early phase, although it may indicate the presence of fluid in the joint. A radionuclide bone scan using Gallium may indicate inflammation in the joint lining.