Traumatic arthrotomy: A systematic review evaluating diagnostic strategies

Area of Science:

• Orthopedic Surgery
• Diagnostic Imaging
• Trauma Care

Background:

• Traumatic arthrotomy, an intra-articular joint injury, poses risks of infection if undiagnosed.
• Accurate and timely diagnosis is crucial for effective management and preventing complications.

Purpose of the Study:

• To systematically review and evaluate diagnostic strategies for traumatic arthrotomy.
• To compare the performance of various diagnostic modalities across different joints.

Main Methods:

• A comprehensive literature search was performed across multiple databases (Ovid Medline, Cochrane, Embase).
• Studies evaluating diagnostic strategies for traumatic arthrotomy were included.
• Data on diagnostic performance, including sensitivity, were extracted and analyzed.

Main Results:

• Twenty-six studies were included, focusing on knee, elbow, shoulder, wrist, and ankle traumatic arthrotomies.
• The saline load test was the most frequently evaluated strategy (23 studies).
• CT scans demonstrated 100% sensitivity for knee traumatic arthrotomy; saline load tests showed high sensitivity (60-100%) for other joints.

Conclusions:

• The saline load test is a reliable diagnostic method for most traumatic arthrotomies, except potentially the knee.
• Imaging modalities like CT scans offer high sensitivity and may be less invasive alternatives for specific joints.
• Clinicians should select diagnostic approaches based on joint-specific performance and potential risks.