Serum Procalcitonin is a sensitive and specific marker in the diagnosis of septic arthritis and acute osteomyelitis

Journal of Orthopaedic Surgery and Research

Sreenivas Thimmaiah¹  Murali Poduval¹  Sabhash Chandra Parija²  Ananthanarayanan Palghat Hariharan³  Jagdish Menon¹  Dilip Kumar Patro¹  Karthikeyan Maharajan¹ 

[1] Department of Orthopedics, JIPMER, Puducherry, India;Department of Microbiology, JIPMER, Puducherry, India;Department of Biochemistry, JIPMER, Puducherry, India

关键词: Marker;    Inflammatory;    Diagnosis;    Osteomyelitis;    Acute;    Arthritis;    Septic;    Procalcitonin;    Serum;   

Others  :  817703
DOI  :  10.1186/1749-799X-8-19

 received in 2011-12-03, accepted in 2013-06-28,  发布年份 2013

【 摘 要 】

Background

Early diagnosis of Acute Osteomyelitis (OM) and Septic Arthritis (SA) is of vital importance to avoid devastating complications. There is no single laboratory marker which is sensitive and specific in diagnosing these infections accurately. Total Count, ESR and CRP are not specific as they can also be elevated in non pyogenic causes of inflammation. Pus Culture and sensitivity is not a true gold standard due to its varied positivity rates (40 – 70%). Serum Procalcitonin (PCT), at 0.5 ng/ml is found to be an accurate marker for pyogenic infections. The objectives of this study were to show that PCT is an accurate marker in differentiating Acute Osteomyelitis and Septic Arthritis from viral and non infective inflammatory bone and joint conditions.

Methods

Patients of all age groups (n = 82) with suspected Acute Osteomyelitis and Septic Arthritis were prospectively included in this study. All patients were subjected to TC, CRP, PCT, IgM Dengue, IgM Chikungunya, pus and blood culture and sensitivity. At the end of the study, patients were classified into 3 groups: Group 1 = Confirmed Pyogenic (n = 27); Group 2 = Presumed Pyogenic (n = 21); Group 3 = Non – infective inflammatory (n = 34).

Results

Group 1 has higher mean PCT levels than Group 2 and 3 (p < 0.05). PCT, at 0.4 ng/ml, was 85.2% sensitive and 87.3% specific in diagnosing Septic Arthritis and Acute Osteomyelitis. In comparison, PCT at conventional cut – off of 0.5 ng/ml is 66.7% sensitive and 91% specific.

Conclusion

Serum Procalcitonin, at a cut – off of 0.4 ng/ml, is a sensitive and specific marker in the diagnosis of Septic Arthritis and Acute Osteomyelitis.

【 授权许可】

   
2013 Karthikeyan et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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