What clinical presentation is most consistent with a diagnosis of septic arthritis?

The clinical presentation most consistent with a diagnosis of septic arthritis is characterized by signs and symptoms that indicate an infection in one or more joints. The correct choice highlights bilateral swelling and warmth of small joints, which aligns with the common physical findings seen in septic arthritis.

In cases of septic arthritis, the affected joints typically present as warm, swollen, and painful due to the inflammation caused by the infection. Patients often report acute joint pain and may have limited range of motion in the involved joints. The bilateral aspect of the swelling, although not always typical of septic arthritis—since it frequently presents unilaterally—can occur in certain cases, particularly due to a systemic infection impacting multiple joints.

The other options present symptoms that are not as indicative of an infectious process. Unilateral joint pain exacerbated by activity suggests mechanical joint issues rather than infection. Bilateral joint stiffness that worsens upon awakening is more characteristic of inflammatory conditions such as rheumatoid arthritis. Intermittent severe joint pain related to diet may point towards conditions such as gout rather than an infection in the joint.

Thus, the bilateral swelling and warmth of small joints more closely align with the acute presentation of septic arthritis, making this option the most consistent with the diagnosis.