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Diagnostic utility of laboratory tests in septic arthritis
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  • Published on:
    response to letter by William Sargent

    We agree that the diagnosis of septic arthritis in the operating room is vulnerable to subjective intrepretation. There was one patient in our study whose diagnosis of septic arthritis was made based on operative findings alone (i.e. without a positive arthrocentesis culture). The operative findings were described as "pus", and we believe that supports the diagnosis of septic arthritis. The patient had been on a c...

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    Conflict of Interest:
    None declared.
  • Published on:
    Gold Standard

    Are 'operative findings' a gold standard for diagnosis of a septic joint? Discussion of interpretation of synovial fluid in Roberts: Clinical Procedures in Emergency Medicine, 4th ed, suggests that gout, pseudogout and other arthritides can give turbid fluid. This clearly has a major impact on interpretation of the data.

    Conflict of Interest:
    None declared.
  • Published on:
    response to Dr. Yasin's letter

    Dear Editor,

    We agree with Dr. Yasin's comment concerning clinical judgment in septic arthritis; it is most important in the assessment of a potentially septic joint, and should not be discounted in the light of "negative" ancillary tests. However, we would like to caution against the use of numerical cut-offs for "positive" and "negative" jWBC. There is considerable overlap in jWBC counts between patients with se...

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    Conflict of Interest:
    None declared.
  • Published on:
    Diagnosing difficulties in Septic Arthritis

    Dear Editor,

    I have read the recent article "Diagnostic utility of laboratory tests in septic arthritis" by S F Li et.al. Septic arthritis is one of the few Orthopaedic emergencies which can be potentially life threatening and requires urgent operative management. It is crucial to rule-out this condition in a patient presenting with monoarticular arthritis, and the gold-standard is aspiration and microscopic exam...

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    Conflict of Interest:
    None declared.