What is the primary concern when dealing with a hot swollen joint?

When a patient presents with a hot, swollen joint, the primary concern is septic arthritis, which is a medical emergency. Septic arthritis occurs when an infection spreads to the joint space, leading to inflammation, pain, and potential joint destruction if not treated promptly. The combination of warmth, swelling, and systemic symptoms like fever can indicate an infectious process that requires immediate evaluation and possibly surgical intervention, such as joint drainage, along with antibiotic therapy.

While fractures can cause swelling and pain, they typically present with a history of trauma and do not usually cause the local heat associated with infection. Chronic gout may lead to swelling and joint pain, particularly in specific joints like the big toe, but it is less likely to present with the acute symptoms of warmth and fever associated with septic arthritis. While rest and ice can help with pain and swelling in various conditions, they do not address the potential underlying infection in the case of septic arthritis, making prompt diagnosis and treatment crucial.