scholarly journals Commentary on an article by Matthew D. Milewski, MD, et al.: “Lyme Arthritis in Children Presenting with Joint Effusions”

2011 ◽  
Vol 93 (3) ◽  
pp. e11-1-2
Author(s):  
R Mervyn Letts
2011 ◽  
Vol 93 (3) ◽  
pp. 252-260 ◽  
Author(s):  
Matthew D Milewski ◽  
Aristides I Cruz ◽  
Christopher P Miller ◽  
Ashley T Peterson ◽  
Brian G Smith

PEDIATRICS ◽  
2016 ◽  
Vol 137 (Supplement 3) ◽  
pp. 566A-566A
Author(s):  
Yi-Meng Yen ◽  
Benjamin J Shore ◽  
Kyna S Donohue ◽  
Patricia E Miller ◽  
Michael Glotzbecker ◽  
...  

2012 ◽  
Vol 42 (16) ◽  
pp. 18
Author(s):  
BRUCE JANCIN
Keyword(s):  

Author(s):  
Robert B. Lochhead ◽  
Klemen Strle ◽  
Sheila L. Arvikar ◽  
Janis J. Weis ◽  
Allen C. Steere
Keyword(s):  

2008 ◽  
Vol 58 (11) ◽  
pp. 3609-3617 ◽  
Author(s):  
Gaia Codolo ◽  
Amedeo Amedei ◽  
Allen C. Steere ◽  
Elena Papinutto ◽  
Andrea Cappon ◽  
...  
Keyword(s):  

2021 ◽  
Vol 6 (1) ◽  
pp. 18
Author(s):  
Javier A. Quintero ◽  
Raluchukwu Attah ◽  
Reena Khianey ◽  
Eugenio Capitle ◽  
Steven E. Schutzer

The diagnosis of Lyme disease, caused by Borrelia burgdorferi, is clinical but frequently supported by laboratory tests. Lyme arthritis is now less frequently seen than at the time of its discovery. However, it still occurs, and it is important to recognize this, the differential diagnoses, and how laboratory tests can be useful and their limitations. The most frequently used diagnostic tests are antibody based. However, antibody testing still suffers from many drawbacks and is only an indirect measure of exposure. In contrast, evolving direct diagnostic methods can indicate active infection.


Author(s):  
Lauren N Pearson ◽  
Robert L Schmidt ◽  
Kenneth Cahoon ◽  
Christopher E Pelt

Abstract Background Total nucleated cell (TNC) count and differential are used to classify joint effusions as inflammatory or noninflammatory. Further diagnostic evaluation and management is contingent on this classification. TNC count can be measured by automated analyzers or by manual assessment using a hemocytometer. Studies have raised concerns regarding the accuracy of TNC counts measured by automated instruments, particularly in the setting of joint arthroplasty. The objective of this study was to determine whether metallosis, a complication of total hip arthroplasty in which metal debris accumulates in periprosthetic tissues and synovial fluid, is associated with inaccurate TNC counts in synovial fluid. Methods We compared the accuracy of cell counts measured by the Sysmex XN-1000 and Beckman Coulter Iris iQ200 with the gold standard of manual assessment using a hemocytometer in synovial fluid from patients with suspected metallosis and in fluid obtained from controls from patients with native joints and a history of arthroplasty for other indications. Results TNC counts produced by automated analyzers were associated with increased levels of discordance (relative to manual counts) in patients with metallosis. Metallosis was not associated with increased levels of discordance for RBC counts or WBC differentials. The Sysmex XN flagged all but 1 metallosis sample for manual verification of the results. Conclusions Automated methods are generally reliable for analysis of synovial fluid. TNC counts can be inaccurate in the context of metallosis following total hip arthroplasty. Laboratories should correlate automated cell counts with a microscopic assessment of the specimen, as recommended by instrument manufacturers.


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