Trauma Department, Hannover Medical School, Hannover, Germany;
Trauma Department, Hannover Medical School, Hannover, Germany.
In Vivo. 2021 May-Jun;35(3):1625-1632. doi: 10.21873/invivo.12420.
BACKGROUND/AIM: Septic arthritis (SA) requires rapid diagnosis and therapy to avoid joint damage. This study evaluated the diagnostic accuracy of leukocyte esterase (LE) and glucose (GLC) strip tests for diagnosing SA.
Synovial fluids from 455 patients with atraumatic joint effusions were assessed prospectively over a 5-year period with LE and glucose strip tests. Results were compared to modified Newman criteria for diagnosing joint infections. Synovial fluid cultures, crystal, blood and synovial cell analyses were also performed.
Forty-one patients had SA and 252 non-SA. A positive LE reading combined with negative glucose reading could detect SA with 100% specificity, 85% sensitivity, 100% positive predictive value (PPV) and 98% negative predictive value (NPV). Positive synovial LE reading alone detected SA with 82% specificity, 95% sensitivity, 47% PPV, and 99% NPV.
Combined LE and glucose strip tests represent a low-cost tool for rapidly diagnosing or ruling out SA.
背景/目的：脓毒性关节炎（SA）需要快速诊断和治疗，以避免关节损伤。本研究评估了白细胞酯酶（LE）和葡萄糖（GLC）条带试验诊断 SA 的准确性。
在 5 年的时间内，对 455 例无创伤性关节积液患者的滑液进行了前瞻性评估，采用 LE 和葡萄糖条带试验进行检测。结果与诊断关节感染的改良 Newman 标准进行了比较。还进行了滑膜液培养、晶体、血液和滑膜细胞分析。
41 例患者为 SA，252 例患者为非 SA。阳性 LE 读数结合阴性葡萄糖读数可检测 SA，特异性为 100%，敏感性为 85%，阳性预测值（PPV）为 100%，阴性预测值（NPV）为 98%。单独阳性滑膜 LE 读数检测 SA 的特异性为 82%，敏感性为 95%，阳性预测值（PPV）为 47%，阴性预测值（NPV）为 99%。
联合 LE 和葡萄糖条带试验是一种快速诊断或排除 SA 的低成本工具。
