The predictive value of synovial glucose level in septic arthritis

Abstract

The aim of this study was to investigate the ability of the joint fluid glucose level to detect septic arthritis. Thirty joints in 30 patients with suspected septic arthritis were evaluated. When glucose level was less than 40 mg/dl, we performed arthrotomy. Eleven patients had joint fluid glucose levels less than 40 mg/dl. All 11 (100%) had positive joint fluid cultures. Conversely, 19 patients had synovial glucose levels of at least 40 mg/dl. Six (31.6%) of these had positive joint fluid cultures. The remaining 13 were diagnosed with transient synovitis. Patients with joint fluid glucose levels less than 40 mg/dl should be suspected septic arthritis.

A Retrospective Review of Native Septic Arthritis in Patients: Can We Diagnose Based on Laboratory Values?

“…Previous studies have attempted to evaluate the diagnostic power of laboratory findings in septic arthritis and have reported conflicting results [5,6,[13][14][15][16][17][18][19]. For example, a systematic review by Margaretten et al evaluated 14 studies in order to determine the most accurate laboratory evaluation for diagnosing septic arthritis [5].…”

Which inflammatory marker is more reliable in diagnosing acute septic arthritis in the pediatric population?

“…Laboratory investigations are not always helpful, but guidelines suggest that WBC, ESR, and CRP evaluation should be performed in the emergency department, even if elevated values are variable and nonspecific. [12][13][14][15] Boccuzzie et al reported that WBC was higher than normal in half of the cases, whereas ESR and CRP in approximately 80% cases. 14 In that study, they reported that WBC seems to perform poorly throughout the spectrum of pediatric osteoarticular infections.…”

“…Laboratory investigations are not always helpful, but guidelines suggest that WBC, ESR, and CRP evaluation should be performed in the emergency department, even if elevated values are variable and nonspecific 12–15 . Boccuzzie et al .…”

Bacterial Lipoproteins Shift Cellular Metabolism to Glycolysis in Macrophages Causing Bone Erosion

“…Similar to these observations, P2C-stimulated BMDMs conferred a switch of metabolism toward a fermentative pathway with a lower oxygen consumption and a larger amount of accumulated lactate, resulting in reduced pH levels. Indeed, higher levels of lactate ( 38 ) and lower levels of glucose ( 39 ) have been described in synovial fluids from septic arthritis versus arthritis caused by other inflammatory mechanisms or by degenerative joint disease. Our in vitro findings closely relate to the observation of in vivo experiments, as, conceivably, the lower pH, decreased by lactate accumulation induced by Lpl1(+sp)-P2C-stimulated monocyte/macrophage cells in vivo , leads to the bone erosions in mouse joints ( Fig.…”