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. …