They also tended to have higher serum CRP levels compared to negative culture patients (median: 142.30 vs. Patients with positive cultures had a larger median % neutrophils than patients with negative cultures (median: 93 vs. Of the 65 patients included in the study, 40 (61.5%) had a positive culture for septic arthritis and 25 (38.5%) had negative cultures. We evaluated the synovial cell count, synovial polymorphonuclear cell percentile (% neutrophils), serum white blood cell (WBC), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) in order to determine their association and predictive power in a true infection. A true infection was considered on the basis of positive or negative synovial aspirate cultures. Exclusion criteria included history of a total joint arthroplasty of the affected joint or immunocompromised state. The purpose of this study was to assess the efficacy of synovial cell counts to predict septic arthritis in patients with symptomatic native joints.Ī retrospective review was performed of patients who were evaluated for septic arthritis at a single institution with the use of synovial fluid analysis and adjunctive lab tests. A synovial fluid cell count of 50,000 cells/mm 3 has been used as a diagnostic cutoff for acute septic arthritis, although data supporting this is lacking. The accurate diagnosis of acute septic arthritis is essential to initiating appropriate treatment and minimizing potential cartilage damage.
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