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Emergency Medicine Journal 2009;26:435-437; doi:10.1136/emj.2009.076240
© 2009 BMJ Publishing Group Ltd and the College of Emergency Medicine.

BEST EVIDENCE TOPIC REPORTS

BET 3 IS THE WHITE CELL COUNT OF THE JOINT ASPIRATE SUFFICIENTLY SENSITIVE/SPECIFIC TO RULE IN/OUT SEPTIC ARTHRITIS?

The first 150 words of the full text of this article appear below.

Report by: Anna O’Malley, Medical Student

Search checked by: Helene Svinos, Medical Student

Institution: University of Manchester, Manchester, UK

A short-cut review was carried out to establish whether the white cell count (WCC) in joint aspirate can rule in or rule out the presence of septic arthritis (SA). A total of 115 citations was reviewed, of which five partly answered the three-part question. The clinical bottom line is that the WCC alone of the joint aspirate does not have the sensitivity or specificity to rule out or rule in SA.

Three-part question

In [adults presenting to the ED with an acute hot joint] is [WBC of the joint aspirate] sufficiently specific and sensitive [to rule in/out septic arthritis].

Clinical scenario

A 20-year-old university student presents to the emergency department with a 2-day history of a hot, swollen joint. She reports no previous knee swelling and no recent trauma or knee surgery, illegal . . . [Full text of this article]


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