Carpenter, Christopher R, Jeremiah D Schuur, Worth W Everett, and Jesse M Pines. “Evidence-based diagnostics: adult septic arthritis..” Academic emergency medicine : official journal of the Society for Academic Emergency Medicine 18, no. 8 (August 2011): 781–796. PMID 21843213
This is a big paper and I confess I skimmed but it says a few things worth commenting on. It’s a huge meta-analysis looking at what may or may not help us in septic arthritis.
It tells us very little apart from cellulitis over a prosthesis is gonna increase the likelihood dramatically.
They make the telling statement:
The overall quality of evidence for the diagnosis of non- gonococcal septic arthritis is relatively low
Which means they’re a bit crippled no matter what they do.
They conclude:
the prevalence of nongonococcal septic arthritis in adults presenting to the ED with acute monoarticular joint complaints to be approximately 27%
Anyone else thinks that’s a ridiculously high number? One in 4 with a single joint complaint have septic arthritis? I’ve seen 10 times as many gouty joints as I have septic ones.
Hey, I love your work, keep it up! I think the take home point for me from this article is that none of the tests or combination of tests we do for this disease is absolute (unlike some of the teaching I had as a resident, or what our Ortho colleagues may like to say to us). BTW check my new favorite EM blogger colleagues over at http://www.alifeatrisk.com/ they have great graphics on the LRs for this on a recent post. Jonathan. http://www.emberproject.org
Hi Jonathan. Cheers for the comment. I think I’m a bit “tap happy” over the last few years. It seems the only way to be sure Enjoying your work as well. Andy