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In vivo Macrophage Imaging Using MR Targeted Contrast Agent for Longitudinal Evaluation of Septic Arthritis
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Identifying Predictive Factors of Pediatric Septic Arthritis of the Knee in a Lyme Endemic Area

Mark J Gage, Kristin D Twomey, Debra A Sala

    Bulletin of the Hospital for Joint Disease (2013)
    |September 13, 2019
    PubMed

    Insights

    Prompt diagnosis of pediatric knee pain is crucial. Fever, negative anti-streptolysin-O, elevated erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) help differentiate septic arthritis from other causes in children.

    Area of Science:

    • Pediatric Orthopedics
    • Rheumatology
    • Infectious Diseases

    Background:

    • Septic arthritis of the knee requires urgent diagnosis and treatment in children.
    • Differentiating septic arthritis from non-septic knee conditions is clinically challenging.

    Purpose of the Study:

    • To identify clinical and laboratory markers for the differential diagnosis of pediatric knee septic arthritis.
    • To distinguish septic arthritis from Lyme arthritis and transient synovitis in pediatric patients.

    Main Methods:

    • Retrospective analysis of 54 pediatric patients with atraumatic isolated knee pain.
    • Inclusion of patients diagnosed with septic arthritis (N=28), Lyme arthritis (N=11), or transient synovitis (N=15).
    • Analysis of clinical and laboratory data to determine predictive factors for septic arthritis.

    Main Results:

    • Fever at presentation, negative anti-streptolysin-O (ASO) test, erythrocyte sedimentation rate (ESR) > 40 mm/hr, and C-reactive protein (CRP) > 20 mg/L were most predictive of septic arthritis.
    • Significantly higher ESR and CRP levels were observed in patients with septic arthritis compared to transient synovitis or Lyme arthritis.

    Conclusions:

    • A combination of clinical and laboratory findings is essential for ruling out septic arthritis in children presenting with atraumatic isolated knee pain.
    • Utilizing fever, ASO, ESR, and CRP can aid in the accurate diagnosis of pediatric knee septic arthritis.
    Abstract

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