Kang Gavrielle, Leow Mabel Q H, Tay Shian-Chao
Singapore General Hospital, Singapore.
J Hand Surg Eur Vol. 2018 May;43(4):431-437. doi: 10.1177/1753193417738166. Epub 2017 Dec 3.
This study aims to identify differences in demographics, clinical and laboratory data between wrist septic arthritis and non-septic arthritis in patients admitted for wrist inflammation. A retrospective review of inpatients from May 2012 to April 2015 was conducted. Seventy-seven patients were included. Non-septic arthritis patients were more likely to have chronic kidney disease, pre-existing gout, or both. All septic arthritis patients had normal serum uric acid levels, and two or more raised inflammatory markers (white cell count, C-reactive protein, erythrocyte sedimentation rate). In patients with isolated wrist inflammation, the mean C-reactive protein in the septic arthritis group was significantly higher compared with the non-septic arthritis group (mean difference 132 mg/L, 95% CI 30.9-234). In this study, polyarticular involvement did not exclude a septic cause; nor did it imply a non-septic aetiology. Diabetic or immunosuppressed patients were not more likely to develop septic arthritis. The presence of chondrocalcinosis on wrist radiographs was virtually diagnostic of non-septic arthritis.
IV.
本研究旨在确定因手腕炎症入院的患者中，手腕化脓性关节炎与非化脓性关节炎在人口统计学、临床和实验室数据方面的差异。对2012年5月至2015年4月的住院患者进行了回顾性研究。共纳入77例患者。非化脓性关节炎患者更易患慢性肾病、既往痛风或两者皆有。所有化脓性关节炎患者血清尿酸水平正常，且有两种或更多炎症指标升高（白细胞计数、C反应蛋白、红细胞沉降率）。在单纯手腕炎症患者中，化脓性关节炎组的平均C反应蛋白水平显著高于非化脓性关节炎组（平均差异132mg/L，95%CI 30.9 - 234）。在本研究中，多关节受累并不排除化脓性病因；也不意味着非化脓性病因。糖尿病或免疫抑制患者发生化脓性关节炎的可能性并不更高。手腕X线片上存在软骨钙质沉着症实际上可诊断为非化脓性关节炎。
IV级。
