Diagnostic Utility of Synovial Fluid Cell Counts and CRP in Pediatric Knee Arthritis: A 10-Year Monocentric, Retrospective Study.

Détails

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Etat: Public
Version: Final published version
Licence: CC BY 4.0
ID Serval
serval:BIB_E1E76DE67855
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Diagnostic Utility of Synovial Fluid Cell Counts and CRP in Pediatric Knee Arthritis: A 10-Year Monocentric, Retrospective Study.
Périodique
Children
Auteur⸱e⸱s
Nyaaba I., Zambelli P.Y., Chaouch A., Bregou A., Uçkay İ., Samara E.
ISSN
2227-9067 (Print)
ISSN-L
2227-9067
Statut éditorial
Publié
Date de publication
08/09/2022
Peer-reviewed
Oui
Volume
9
Numéro
9
Pages
1367
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: epublish
Résumé
Orthopedic surgeons often use the intra-articular white blood counts (WBCs) and the percentage of polymorphonuclear cells (PMN) in the diagnosis of an acute swollen and painful knee joint in children. Today, there is no established threshold for the synovial WBC, and their differentiation, as indicative of native joint knee bacterial arthritis. We determine the sensitivity and specificity of synovial WBCs and PMN percentages in the prediction of a community-acquired, acute bacterial native joint septic arthritis (SA) in the pediatric population.
A retrospective study on healthy children 0-16 years of age who underwent knee joint aspiration for a community-acquired, acute irritable knee effusion in our tertiary-care children's hospital between May 2009 and April 2019 was conducted. We divided the study population into two groups according to the detection of bacterial arthritis in the synovial fluid (bacterial arthritis versus its absence) and compared the intra-articular leukocyte and C-reactive protein (CRP) levels.
Overall, we found a statistically significant difference regarding the total CRP (p = 0.017), leukocyte or PMN counts (p ≤ 0.001 in favor of a bacterial arthritis). In contrast, the percentage of the neutrophils was not determinant for the later confirmation of bacterial pathogens, and we were unable to establish diagnostically determining minimal thresholds of the intra-articular CRP and leukocyte levels.
This pilot study suggests that either the leukocyte or PMN counts may be associated with a bacterial origin of knee arthritis in children. We plan a larger prospective interventional study in the future to confirm these findings including the investigation of other joint aspirate biomarkers.
Mots-clé
Pediatrics, Perinatology and Child Health, CRP, diagnosis, knee arthritis, leucocyte counts, synovial fluid
Pubmed
Web of science
Open Access
Oui
Création de la notice
10/09/2022 19:00
Dernière modification de la notice
21/11/2022 6:44
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