BEST EVIDENCE TOPIC REPORTS
BET 3 IS THE WHITE CELL COUNT OF THE JOINT ASPIRATE SUFFICIENTLY SENSITIVE/SPECIFIC TO RULE IN/OUT SEPTIC ARTHRITIS?
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Report by: Anna OMalley, 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.
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].
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
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