False-negative joint aspiration of septic arthritis of the hip in neonates

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Soon Hyuck Lee ◽  
Ji Hun Park ◽  
Jin Hyeok Lee ◽  
Woo Young Jang
Keyword(s):  
Septic Arthritis ◽  
False Negative ◽  
Joint Aspiration

scholarly journals Current Variation in Joint Aspiration Practice for the Evaluation of Pediatric Septic Arthritis

2020 ◽  
Vol 4 (9) ◽  
pp. e20.00133
Author(s):  
K. Aaron Shaw ◽  
Ryan Sanborn ◽  
Benjamin Shore ◽  
Walter Truong ◽  
Joshua S. Murphy ◽  
...  
Keyword(s):  
Septic Arthritis ◽  
Joint Aspiration ◽  
Current Variation

Septic Arthritis and Joint Aspiration: The Radiologist’s Role in Image-Guided Aspiration for Suspected Septic Arthritis

2019 ◽  
Vol 54 (2) ◽  
pp. 177-189 ◽  
Author(s):  
Jack Porrino ◽  
Michael L. Richardson ◽  
Erin Flaherty ◽  
Mahmood Albahhar ◽  
Alice S. Ha ◽  
...  
Keyword(s):  
Septic Arthritis ◽  
Image Guided ◽  
Joint Aspiration

scholarly journals Septic arthritis of the knee: the use and effect of antibiotics prior to diagnostic aspiration

2012 ◽  
Vol 94 (5) ◽  
pp. 351-355 ◽  
Author(s):  
P Hindle ◽  
E Davidson ◽  
LC Biant
Keyword(s):  
Septic Arthritis ◽  
Joint Infection ◽  
False Negative ◽  
False Negative Rate ◽  
Standard Test ◽  
Entire Cohort ◽  
High False Negative Rate ◽  
Total Knee ◽  
Prosthetic Knees ◽  
No Gold Standard

Septic arthritis of the native knee joint and total knee arthroplasty both cause diagnostic and treatment issues. There is no gold standard test to diagnose a joint infection and the use of joint aspiration is commonly relied on. It is widely accepted by orthopaedic surgeons that antibiotics should be withheld until aspiration has been performed to increase the odds of identifying an organism. Patients often present to other specialties that may not be as familiar with these principles. Our study found that 25 (51%) of the 49 patients treated for septic arthritis of the native or prosthetic knee in our unit over a 3-year period had received antibiotics prior to discussion or review by the on-call orthopaedic service. Patients were significantly less likely to demonstrate an organism on initial microscopy (entire cohort: p=0.001, native knees: p=0.006, prosthetic knees: p=0.033) or on subsequent culture (entire cohort: p=0.001, native knees: p=0.017, prosthetic knees: p=0.012) of their aspirate if they had received antibiotics. The sensitivity of microscopy in all patients dropped from 58% to 12% when patients had received antibiotics (native knees: 46% to 0%, prosthetic knees: 72% to 27%). The sensitivity of the culture dropped from 79% to 28% in all patients when the patient had received antibiotics (native knees: 69% to 21%, prosthetic knees: 91% to 36%). This study demonstrated how the management of patients with suspected cases of septic arthritis of the knee may be compromised by empirical administration of antibiotics. These patients were significantly less likely to demonstrate an organism on microscopy and culture of their initial aspirate. There is a significant high false negative rate associated with knee aspiration with prior administration of antibiotic therapy.

scholarly journals Arthroscopic Treatment of Septic Arthritis of the Elbow in a 4-Year-Old Girl

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Masashi Koide ◽  
Yuichi Tojo ◽  
Yoshihiro Hagiwara ◽  
Souichi Nakajima ◽  
Minoru Tanaka ◽  
...  
Keyword(s):  
Septic Arthritis ◽  
Clinical Condition ◽  
Arthroscopic Surgery ◽  
Arthroscopic Treatment ◽  
Joint Aspiration ◽  
Good Clinical Condition ◽  
Open Arthrotomy

Pediatric septic arthritis is uncommon and has been traditionally treated by joint aspiration or open arthrotomy. There are some reports about arthroscopic surgery in pediatric septic arthritis of the knee, hip, and shoulder. However, there is no report for the case of elbow. We report a case of pediatric septic arthritis of elbow treated with arthroscopically with good clinical condition at 3-year follow-up. This paper is based on a report first published in Japanese (Tojo (2012)).

scholarly journals Septic arthritis of ankle joint in the paediatric age group: a retrospective study

2020 ◽  
Vol 6 (3) ◽  
pp. 442
Author(s):  
Nasiur Rehman ◽  
Marcin Zgoda ◽  
Mohamed K. Osman
Keyword(s):  
Retrospective Study ◽  
Knee Joint ◽  
Septic Arthritis ◽  
Joint Infection ◽  
Positive Culture ◽  
Causative Organism ◽  
Age Group ◽  
Laboratory Findings ◽  
Joint Aspiration ◽  
Paediatric Age

<p class="abstract"><strong>Background:</strong> Septic arthritis in paediatric age group poses a significant clinical problem. Common sites are hip and knee joint. There are several orthopaedic literatures available on septic arthritis of the hip and knee joint, however, literature on epidemiology, causative organisms and outcome of septic arthritis of the ankle are very few.</p><p class="abstract"><strong>Methods:</strong> We conducted a retrospective study at a tertiary hospital with an aim to evaluate the incidence, causative pathogen, outcome and to identify differences, if any, between clinical features and laboratory findings of these patients when compared to those with hip and knee joint infection.<strong></strong></p><p class="abstract"><strong>Results:</strong> 47 children were diagnosed with septic arthritis, of which, 14 had septic arthritis of the ankle. Mean age was 5.2 years (8 months - 12 years). 13 children had undergone joint aspiration as a primary procedure. 50% (7) children had positive culture. <em>Streptococcus pyogenes</em> was the commonest causative organism in our cohort (29%) followed by <em>Staphylococcus aureus</em>. Mean follow-up was 36 months (16 - 56 months). 13 children (93%) had good clinical outcome. 1 child developed early arthritis.</p><p class="abstract"><strong>Conclusions:</strong> Septic arthritis of the ankle is a serious condition. Even-though the joint is superficial, diagnosing it clinically can be difficult due to less pronounced symptoms. This can lead to delay in establishing the diagnosis and commencing treatment, hence, it is imperative to have a high index of suspicion. We found early joint aspiration followed by a course of antibiotics to be an effective regimen in management of this devastating condition.</p>

scholarly journals False-Negative Rate of Gram-Stain Microscopy for Diagnosis of Septic Arthritis: Suggestions for Improvement

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Paul Stirling ◽  
Radwane Faroug ◽  
Suheil Amanat ◽  
Abdulkhaled Ahmed ◽  
Malcolm Armstrong ◽  
...  
Keyword(s):  
Synovial Fluid ◽  
Septic Arthritis ◽  
False Negative ◽  
False Negative Rate ◽  
Diagnostic Value ◽  
Royal Infirmary ◽  
Gram Stain ◽  
Data Set ◽  
Ongoing Research ◽  
Negative Rate

We quantify the false-negative diagnostic rate of septic arthritis using Gram-stain microscopy of synovial fluid and compare this to values reported in the peer-reviewed literature. We propose a method of improving the diagnostic value of Gram-stain microscopy using Lithium Heparin containers that prevent synovial fluid coagulation. Retrospective study of the Manchester Royal Infirmary microbiology database of patients undergoing synovial fluid Gram-stain and culture between December 2003 and March 2012 was undertaken. The initial cohort of 1896 synovial fluid analyses for suspected septic arthritis was reduced to 143 after exclusion criteria were applied. Analysis of our Gram-stain microscopy yielded 111 false-negative results from a cohort size of 143 positive synovial fluid cultures, giving a false-negative rate of 78%. We report a false-negative rate of Gram-stain microscopy for septic arthritis of 78%. Clinicians should therefore avoid the investigation until a statistically significant data set confirms its efficacy. The investigation's value could be improved by using Lithium Heparin containers to collect homogenous synovial fluid samples. Ongoing research aims to establish how much this could reduce the false-negative rate.

Abklärung Monarthritis – Schritt für Schritt

2019 ◽  
Vol 144 (22) ◽  
pp. 1585-1589
Author(s):  
Boris Ehrenstein
Keyword(s):  
Septic Arthritis ◽  
Leucocyte Count ◽  
Joint Damage ◽  
Inflammatory Rheumatic Diseases ◽  
Fluid Sample ◽  
Infectious Arthritis ◽  
Joint Aspiration ◽  
Gram Staining ◽  
High Urgency ◽  
Work Up

AbstractThe work-up of acute monoarthritis is challenging due to the abundance of differential diagnoses. In addition to a bacterial septic arthritis, which can, if not treated promptly, cause rapid irreversible joint damage, many diseases have to be considered: inflammatory rheumatic diseases, activated osteoarthritis, other infectious arthritis, cristal induced arthritis, and rare tumorous diseases. In cases with high urgency, and/or when medical history, physical examination and laboratory parameters remain without a specific etiologic clue, septic arthritis has to be excluded by immediate diagnostic joint aspiration. In many patients the cause of monoarthritis can already be determined by ordering a leucocyte count of the synovial fluid sample, a microscopy for crystals, and gram staining and culture for bacterial pathogens.

Causes of False-Negative Ultrasound Scans in the Diagnosis of Septic Arthritis of the Hip in Children

2002 ◽  
Vol 22 (3) ◽  
pp. 312-316 ◽  
Author(s):  
J. Eric Gordon ◽  
Michael Huang ◽  
Matthew Dobbs ◽  
Scott J. Luhmann ◽  
Deborah A. Szymanski ◽  
...  
Keyword(s):  
Septic Arthritis ◽  
False Negative

scholarly journals Joint aspiration for suspected septic arthritis – are we requesting the right investigations?

2018 ◽  
Vol 55 ◽  
pp. S80
Author(s):  
J. Baker ◽  
G. Manoharan ◽  
M. Hamadto ◽  
D. Griffiths
Keyword(s):  
Septic Arthritis ◽  
Joint Aspiration ◽  
The Right

scholarly journals Arthritis in children: comparison of clinical and biological characteristics of septic arthritis and juvenile idiopathic arthritis

2016 ◽  
Vol 102 (4) ◽  
pp. 316-322 ◽  
Author(s):  
Camille Aupiais ◽  
Romain Basmaci ◽  
Brice Ilharreborde ◽  
Audrey Blachier ◽  
Marie Desmarest ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Septic Arthritis ◽  
Tertiary Care ◽  
Age At Onset ◽  
First Episode ◽  
Tertiary Care Centre ◽  
Term Outcome ◽  
Duration Of Symptoms ◽  
Disease Evolution ◽  
Joint Aspiration

AimChildhood arthritis arises from several causes. The aim of this observational study is to compare the clinical and biological features and short-term outcome of different types of arthritis because they have different treatment and prognoses.MethodsChildren <16 years of age hospitalised in a French tertiary care centre for a first episode of arthritis lasting for less than 6 weeks who underwent joint aspiration were retrospectively included. We performed non-parametrical tests to compare groups (septic arthritis (SA), juvenile idiopathic arthritis (JIA) and arthritis with no definitive diagnosis). The time before apyrexia or C reactive protein (CRP) <10 mg/L was analysed using the Kaplan-Meier method.ResultsWe studied 125 children with a sex ratio (M/F) of 1.1 and a median age of 2.2 years (range 0.3 to 14.6). SA was associated with a lower age at onset (1.5 years, IQR 1.2–3.0 vs 3.6 years, IQR 2.2–5.6), shorter duration of symptoms before diagnosis (2 days, IQR 1–4 vs 7 days, IQR 1–19) and higher synovial white blood cell count (147 cells ×103/mm3, IQR 71–227, vs 51 cells ×103/mm3, IQR 12–113), than JIA. Apyrexia occurred later in children with JIA (40% after 2 days, 95% CI 17% to 75%) than children with SA (82%, 95% CI 68% to 92%), as did CRP<10 mg/L (18% at 7 days, 95% CI 6.3% to 29.6% vs 82.1%, 95% CI 76.1% to 89.7%, p=0.01).ConclusionsThere were no sufficiently reliable predictors for differentiating between SA and JIA at onset. The outcomes were different; JIA should be considered in cases of poor disease evolution after antibiotic treatment and joint aspiration.

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