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在急性单关节炎中感染性关节炎的前发烧或刚度的预测值:一项追溯观察性研究
1Department of Emergency and General Medicine, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan.
The American journal of emergency medicine
|October 25, 2025
概括
在关节症状出现之前的发烧或刚性显著增加了感染性关节炎 (SA) 的可能性. 这种时间关系对于在急性单关节炎病例中准确的SA诊断至关重要.
科学领域:
- 传染性疾病 传染性疾病
- 类风湿病学 类风湿病学
- 临床诊断 临床诊断 临床诊断
背景情况:
- 败血性关节炎 (SA) 诊断往往忽略了相对于关节症状的发烧时间.
- 之前的研究还没有完全探索发烧的预测价值关于系统和关节的表现.
研究的目的:
- 为了评估发烧和关节症状发作之前的严格的诊断实用性,用于识别败血性关节炎.
- 为了比较早期发烧/硬度与发烧/硬度在陈述期间的任何时候的诊断准确度.
主要方法:
- 对234名患有急性单关节炎的成年患者进行了回顾性审查,这些患者接受了膜液分析.
- 使用修改的纽曼标准定义了败血性关节炎.
- 发烧/硬度的诊断准确性比较 ≥1天前关节症状与任何时间的发烧/硬度.
主要成果:
- 败血性关节炎在7.7%的患者中被诊断出.
- 在关节症状出现前1天以上的发烧或刚性,对SA的敏感度为27.8%,特异性为96.8%.
- 早期发烧/硬度的阳性概率比率为8.57,明显高于任何时间发烧 (PLR 1.59).
- 仅严度对SA的敏感性为0%.
结论:
- 在关节症状出现之前出现发烧或刚性,增加了感染性关节炎的可能性.
- 临床医生应强调系统性和关节性症状之间的时间关系,以改善SA诊断.
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