Limits of Diagnostic Testing for Detecting Prosthetic Joint Infection

Recommended screening studies have less than 90% sensitivity for chronic periprosthetic joint infections.

Determining if a patient has periprosthetic joint infection (PJI) is a diagnostic challenge. Guidelines from both the Infectious Diseases Society of America and the American Academy of Orthopedic Surgeons recommend measurement of serum C-reactive protein (CRP), the erythrocyte sedimentation rate (ESR), and synovial fluid white blood cell (WBC) count and differential as initial screening assays when PJI is suspected. Researchers at one academic medical center reviewed the utility of these assays for diagnosing chronic PJI infections in 549 patients with confirmed PJI and 653 patients who underwent total joint arthroplasty revisions for reasons other than infection.

The mean ESR, CRP, synovial WBC count, and synovial fluid neutrophil percentag…

Reviewing Author

Richard T. Ellison III, MD

Disclosures

Consult/Advisory BoardAcurx Pharmaceuticals, LLC;

Grant/Research SupportDoctors Company Foundation, Massachusetts Department of Public Health

Richard T. Ellison III, MD

Disclosures

Consult/Advisory BoardAcurx Pharmaceuticals, LLC;

Grant/Research SupportDoctors Company Foundation, Massachusetts Department of Public Health

Limits of Diagnostic Testing for Detecting Prosthetic Joint Infection

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Reviewing Author