Abstract
IntroductionSuspected septic arthritis is a common presentation to EDs. The underlying diagnosis is often non-infective pathology. Differentiating between aetiologies is difficult. A bedside test with high negative predictive value (NPV)...
Highlights
Suspected septic arthritis is a common presentation to Emergency Departments
All (5/5) infected cases showed ≥2+ leucocyte esterase test (LE), sensitivity of 100% while the Gram stain was positive in only one case
Twenty-three LE were read negative or 1+, all with negative 48-hour culture results resulting in a negative predictive value (NPV) of 100% for a negative leucocyte esterase strip testing (LE test)
Summary
Suspected septic arthritis is a common presentation to Emergency Departments. Bacterial septic arthritis is an orthopaedic emergency. In the adult population referrals to the orthopaedic team for suspected native joint infection (NJI) are common; incidence is low, 7.8 per 100,000 in the UK [1]. Risk factors for septic arthritis include: extremes of age, diabetes mellitus, intravenous drug use, rheumatoid arthritis, osteoarthritis, joint surgery, haemodialysis, human immunodeficiency virus (HIV) and immunosuppression [4, 5]. Proteolytic enzymes which are released by bacteria destroy articular cartilage [6]. This can occur as early as 1-2 days if left untreated [7]. Research by Freed et al suggested that it commonly takes up to 3 days to confirm the aetiology on history, examination and synovial examination [10]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
