Septic arthritis laboratory findings: Difference between revisions
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==Overview== | ==Overview== | ||
==Diagnosis== | |||
The diagnosis of septic arthritic can be difficult as no test is able to completely rule out the possibility. | |||
====Laboratory Tests==== | |||
A number of factors should increase ones suspicion of the presence of an infection. In children these are: [[fever]] > 38.5 C, non weight bearing, serum WCBs > 12 x 10^9, [[ESR]] > 40 mm/hr, [[CRP]] > 20 mg/dL, a previous visit for the same.<ref>{{cite web |url=http://www.bestbets.org/bets/bet.php?id=1072 |title=BestBets: Distinguishing between septic arthritis of the hip and transient synovitis in children |format= |work= |accessdate=}}</ref> | |||
====Joint Fluid Aspiration==== | |||
Diagnosis is by aspiration (giving a turbid, non-viscous fluid), [[Gram stain]] and [[microbiological culture|culture]] of fluid from the joint, as well as tell-tale signs in laboratory testing (such as a highly elevated [[neutrophils]] (approx. 90%), [[Erythrocyte sedimentation rate|ESR]] or [[CRP]]). A proportion of patients with septic arthritis have little in the way of fever or raised ESR, although the CRP is usually raised <ref>{{cite journal |author=Geirsson AJ, Statkevicius S, Víkingsson A |title=Septic arthritis in Iceland 1990-2002: increasing incidence due to iatrogenic infections |journal=Ann Rheum Dis. |volume=67 |issue=5 |pages=638–43 |year=2008 |month=May |pmid=17901088 |doi=10.1136/ard.2007.077131 |url=}}</ref> | |||
====Gram Stain==== | |||
The Gram stain can rule in the diagnosis of septic arthritis however cannot exclude it.<ref>{{cite web |url=http://www.bestbets.org/bets/bet.php?id=1636 |title=BestBets: Is a negative gram stain in suspected septic arthritis sufficient to rule out septic arthritis |format= |work= |accessdate=}}</ref> | |||
==References== | ==References== | ||
Revision as of 05:21, 2 February 2012
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Jumana Nagarwala, M.D., Senior Staff Physician, Department of Emergency Medicine, Henry Ford Hospital; Cafer Zorkun, M.D., Ph.D. [2]
Overview
Diagnosis
The diagnosis of septic arthritic can be difficult as no test is able to completely rule out the possibility.
Laboratory Tests
A number of factors should increase ones suspicion of the presence of an infection. In children these are: fever > 38.5 C, non weight bearing, serum WCBs > 12 x 10^9, ESR > 40 mm/hr, CRP > 20 mg/dL, a previous visit for the same.[1]
Joint Fluid Aspiration
Diagnosis is by aspiration (giving a turbid, non-viscous fluid), Gram stain and culture of fluid from the joint, as well as tell-tale signs in laboratory testing (such as a highly elevated neutrophils (approx. 90%), ESR or CRP). A proportion of patients with septic arthritis have little in the way of fever or raised ESR, although the CRP is usually raised [2]
Gram Stain
The Gram stain can rule in the diagnosis of septic arthritis however cannot exclude it.[3]
References
- ↑ "BestBets: Distinguishing between septic arthritis of the hip and transient synovitis in children".
- ↑ Geirsson AJ, Statkevicius S, Víkingsson A (2008). "Septic arthritis in Iceland 1990-2002: increasing incidence due to iatrogenic infections". Ann Rheum Dis. 67 (5): 638–43. doi:10.1136/ard.2007.077131. PMID 17901088. Unknown parameter
|month=ignored (help) - ↑ "BestBets: Is a negative gram stain in suspected septic arthritis sufficient to rule out septic arthritis".