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In patients with acute inflammatory monoarthritis, crystal disease and bacterial infection are usually the two principal considerations; on rare occasions, both are present. In a retrospective study from an Australian tertiary care hospital, researchers determined the incidence and characteristics of concomitant septic and crystal arthritis by examining records of all patients who underwent arthrocentesis and synovial fluid analysis.
During 5 years, 82 patients had culture-proven septic arthritis only, 295 had crystal arthritis only (about 55% gout and 45% pseudogout), and 22 had both crystal and septic arthritis. Most patients in each category had markedly elevated synovial fluid white blood cell (WBC) counts and serum C-reactive protein (C…