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Old 02-04-2013
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Default Prosthetic joint infection ?

What is the best initial and most accurate test for prosthetic joint infection ?

X-rays or CT scan.....MRI.
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Quote:
Originally Posted by aknz View Post
What is the best initial and most accurate test for prosthetic joint infection ?

X-rays or CT scan.....MRI.
X-ray & CT scan.
You can't do MRI with a metal inside.

More on Prosthetic Joint infection here

and here
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Quote:
Originally Posted by Novobiocin View Post
X-ray & CT scan.
You can't do MRI with a metal inside.

More on Prosthetic Joint infection here

and here
Most accurate test: None of the above.

You don't want to mess about with a prosthetic joint infection - most accurate is arthrocentesis with cell count and culture.
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Diagnosis and Management of Prosthetic Joint Infection

Latest guidelines Dec 2012 algorithm



Quote:
A plain radiograph should be performed in all patients with suspected PJI
Quote:
A diagnostic arthrocentesis should be performed in all patients with suspected acute PJI unless the diagnosis is evident clinically and surgery is planned and antimicrobials can be safely withheld prior to surgery. Arthrocentesis is also advised in patients with a chronic painful prosthesis in whom there is an unexplained elevated sedimentation rate or CRP level (A-III) or in whom there is a clinical suspicion of PJI. It may not be necessary if in this situation surgery is planned and the result is not expected to alter management. Synovial fluid analysis should include a total cell count and differential leukocyte count, as well as culture for aerobic and anaerobic organisms (A-III). A crystal analysis can also be performed if clinically indicated.
Quote:
Imaging studies such as bone scans, leukocyte scans, magnetic resonance imaging, computed tomography, and positron emission tomography scans should not be routinely used to diagnose PJI
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Last edited by Novobiocin; 02-04-2013 at 04:43 PM.
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Old 02-04-2013
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Quote:
Originally Posted by Novobiocin View Post
Interesting that you mentioned "Xray AND CT scan" above. Might it be possible to elucidate why you said this?

Edit: Never mind, I just saw the last quote in your response above.
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