Kriegsmann J, Hopf T, Jacobs D, Arens N, Krenn V, Schmitt-Wiedhoff R, Kriegsmann M, Heisel C, Biehl C, Thabe H, Schmitz R P H, Lehmann M, Otto M
Zentrum für Histologie, Zytologie und Molekulare Diagnostik, Max-Planck-Strasse, Trier, Deutschland.
Orthopade. 2009 Jun;38(6):531-8. doi: 10.1007/s00132-008-1394-2.
The diagnosis of infections in patients with arthritis and/or joint prostheses requires interdisciplinary cooperation and the use of up-to-date methods. Massive bacterial infection can be identified by bacterial culture, and minimal infection can be detected by molecular pathological methods. These processes include specific enrichment of bacterial and fungal DNA, amplification, and identification of the DNA by gel electrophoresis, sequencing techniques, and chip technologies.Anamnesis (enteral or urogenital infection), the clinical picture (oligoarthritis), and further parameters (e.g., HLA B27 status) are important for the diagnosis of reactive arthritis. In many cases of reactive arthritis, molecular methods allow detection of bacterial DNA or RNA in synovial fluid or tissue. Molecular pathological methods allow the fast and reliable differential diagnosis of granulomatous synovialitis without prior cultivation of bacteria or fungi. The development of new molecular pathological methods for detecting bacterial and fungal nucleic acids will increase diagnostic accuracy.
关节炎患者和/或关节假体患者感染的诊断需要多学科合作并采用最新方法。大量细菌感染可通过细菌培养来识别,微量感染可通过分子病理学方法检测。这些过程包括细菌和真菌DNA的特异性富集、扩增,以及通过凝胶电泳、测序技术和芯片技术对DNA进行鉴定。病史(肠道或泌尿生殖系统感染)、临床表现(寡关节炎)以及其他参数(如HLA B27状态)对于反应性关节炎的诊断很重要。在许多反应性关节炎病例中,分子方法可检测滑液或组织中的细菌DNA或RNA。分子病理学方法无需事先培养细菌或真菌就能快速可靠地鉴别肉芽肿性滑膜炎。用于检测细菌和真菌核酸的新分子病理学方法的开发将提高诊断准确性。