Related Experiment Video
Updated: Oct 26, 2025

Novel Diagnostics in Revision Arthroplasty: Implant Sonication and Multiplex Polymerase Chain Reaction
Published on: December 3, 2017
Diagnosing a periprosthetic shoulder infection: A systematic review
Julio J Jauregui1, Andrew Tran1, Samir Kaveeshwar1
1Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD, USA.
Introduction:
The aim of this study was to systematically review the literature regarding accurate shoulder prosthetic joint infection (PJI) diagnosis.
Methods:
Using PRISMA guidelines, we analyzed 25 studies reporting on 5535 patients and 646 infections.
Results:
Cutibacterium acnes (C. acnes) cultures were positive in 60% of patients. Serum markers WBC, CRP, ESR, and IL-6 appear to lack diagnostic reliability. Synovial IL-6 and alpha-defensin may be more accurate in detecting infections.
Conclusion:
Synovial IL-6 and alpha-defensin appear to have greater utility than serum markers. These may be incorporated into new criteria to accurately diagnose shoulder PJI.
Level Of Evidence:
IV.
Related Concept Videos
Acute Pyelonephritis II: Diagnostic Studies and Management
Endocarditis III: Medical Management
Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care
Acute Pyelonephritis I: Introduction

