Rapid exclusion of bacterial arthritis using a glucometer
Mohamed Omar1, Moritz Reichling2, Emmanouil Liodakis2
1Trauma Department, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany. omar.mohamed@mh-hannover.de.
Clinical Rheumatology
|April 14, 2016
Summary
Diagnosing bacterial arthritis can be difficult. This study shows a glucometer can accurately measure synovial fluid glucose, offering a simple tool to aid in diagnosing bacterial arthritis.
Area of Science:
- Medical Diagnostics
- Infectious Diseases
- Rheumatology
Background:
- Bacterial arthritis requires urgent diagnosis, but differentiating it from non-infectious conditions is challenging.
- Bacterial metabolism reduces glucose levels, making synovial fluid glucose a potential diagnostic marker.
Purpose of the Study:
- To assess the accuracy of glucometer measurement of synovial fluid glucose.
- To evaluate the diagnostic accuracy of synovial fluid glucose for bacterial arthritis compared to existing markers.
Main Methods:
- Prospective diagnostic study of 102 patients with joint effusion.
- Synovial fluid glucose measured by glucometer and automated analyzer.
- Comparison with synovial fluid culture, crystal analysis, cell analysis, and serum markers.
Main Results:
- High correlation (r² = 0.92) between glucometer and automated analyzer for synovial fluid glucose.
- A threshold of 1.4 mmol/l demonstrated 100% sensitivity and 92.0% specificity for bacterial arthritis.
- Negative predictive value was 100%, indicating reliable exclusion of bacterial arthritis.
Conclusions:
- Synovial fluid glucose can be reliably measured using a simple glucometer.
- Glucometer-based synovial fluid glucose testing shows potential as an adjunct diagnostic tool for bacterial arthritis.
