The test is typically requested by a healthcare provider when a person has symptoms of a joint infection, such as pain, swelling, redness, warmth, and stiffness. The test may also be ordered if a person has an increased risk of joint infection, such as those with weakened immune systems, recent joint surgery, or a history of joint infections. It is important to note that a joint fluid gram stain is just one test that is used to diagnose joint infections, and other tests, such as imaging studies or blood tests, may also be necessary. Additionally, false-negative results may occur if there are only a small number of bacteria in the joint fluid or if the sample is not collected correctly.