Diagnostic Criteria for Septic Arthritis

Study Overview
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Brief Summary
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Septic arthritis (SA) is a rare but highly disabling disease. The ideal diagnosis criteria is not well established. There is an urgent need to establish golden standard for diagnosis.

Detailed Description
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Septic arthritis (SA) is a rare but highly disabling disease. Epidemiologic studies have documented an incidence of 0.9-1.3 per 100,000 [1, 2]. The treatment is challenging and the ideal diagnosis criteria is not well established. The specific tactics employed by relevant researches varied widely [3-6]. Patients with recurrent sepsis may require arthrodesis or amputation, which would result in severe functional loss [2]. Therefore, there is an urgent need to establish golden standard for diagnosis.

Official Title
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Investigation on Diagnostic Criteria for Septic Arthritis：a Multi-center Nested Case-control Study

Conditions
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Septic Arthritis

Intervention / Treatment
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* Diagnostic Test: Laboratory test
* Diagnostic Test: History taking and physical examination
* Diagnostic Test: biopsy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: admission to orthopaedics complete data Exclusion Criteria: Accompanied with fracture Accompanied with other infections Accompanied with immune system diseases

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Cases<br>Patients with septic arthritis | Diagnostic Test: Laboratory test<br>* including white blood cell count, C-reactive protein, erythrocyte sedimentation rate, percent of polymorphonuclear leukocytes, albumin, and globulin<br>Diagnostic Test: History taking and physical examination<br>* including fever, joint pain, local swelling and redness, sinus<br>Diagnostic Test: biopsy<br>* including arthrocentesis culture，and frozen section<br>|
| Controls<br>Patients with osteoarthritis, rheumatoid arthritis | Diagnostic Test: Laboratory test<br>* including white blood cell count, C-reactive protein, erythrocyte sedimentation rate, percent of polymorphonuclear leukocytes, albumin, and globulin<br>Diagnostic Test: History taking and physical examination<br>* including fever, joint pain, local swelling and redness, sinus<br>Diagnostic Test: biopsy<br>* including arthrocentesis culture，and frozen section<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| WBC counts | white blood cell (WBC) counts | preoperatively | 
| %PMN | percent of polymorphonuclear leukocytes (%PMN) | preoperatively | 
| CRP | concentration of C-reactive protein (CRP) | preoperatively | 
| ESR | erythrocyte sedimentation rate (ESR) | preoperatively | 
| Albumin | concentration of albumin | preoperatively | 
| Globulin | concentration of globulin | preoperatively | 
| Body temperature | to check whether there has been a fever (>37.2°C) previously or now by medical history consultation and physical examination | preoperatively | 
| joint swelling and redness | to check whether there is joint swelling and redness by visual inspection and palpation | preoperatively | 
| sinus tract | to check whether there is any sinus tract by visual inspection | preoperatively | 
| positive X-ray findings | to determine whether there are positive X-ray findings, such as bone destruction, narrowing of the joint space, etc. | preoperatively | 
| positive MR findings | to determine whether there are positive MR findings, such as joint effusion, cartilage damage, etc. | preoperatively | 
| positive pathological findings | determined by 5 or more neutrophils per high-power field on histopathologic examination | intraoperatively | 
| positive culture | determined by a bacterial growth when culture of blood or joint fluid in agarose | preoperatively | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Septic Arthritis, diagnostic criteria