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HSS Journal ®
Published in: HSS Journal ® 2/2016

01-07-2016 | Evidence Based Review in Orthopedics

Diagnosing Septic Arthritis in the Synovial White Cell Count “Gray Zone”

Authors: Joseph J. Ruzbarsky, MD, Brian P. Gladnick, MD, Emily Dodwell, MD, MPH

Published in: HSS Journal ® | Issue 2/2016

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Abstract

Differentiating septic arthritis of the pediatric hip from other causes of hip pain and effusion continues to present a diagnostic challenge for the clinician. Although septic arthritis traditionally has been reported to have a synovial white blood cell count of 75,000 cells/mm3 or greater, lower counts can be seen in this condition. In cases where a synovial sample has been obtained and the cell count falls in the intermediate range between 25,000 and 75,000 cells/mm3, it is unclear what proportion of these cases may be truly septic hips. In this evidence-based review, we examine Heyworth et al’s study focusing on the predictive value of this intermediate white cell count range in a Lyme-endemic region.
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Literature
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Kocher MS, Zurakowski D, Kasser JR. Differentiating between septic arthritis and transient synovitis of the hip in children: an evidence-based clinical prediction algorithm. J Bone Joint Surg Am. 1999; 81: 1662-1670.PubMed
2.
Caird MS, Flynn JM, Leung YL, Millman JE, D'Italia JG, Dormans JP. Factors distinguishing septic arthritis from transient synovitis of the hip in children. A prospective study. J Bone Joint Surg Am. 2006; 88: 1251-1257.CrossRefPubMed
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Alderson M, Nade S. Natural history of acute septic arthritis in an avian model. J Orthop Res. 1987; 5: 261-274.CrossRefPubMed
Metadata
Title
Diagnosing Septic Arthritis in the Synovial White Cell Count “Gray Zone”
Authors
Joseph J. Ruzbarsky, MD
Brian P. Gladnick, MD
Emily Dodwell, MD, MPH
Publication date
01-07-2016
Publisher
Springer US
Published in
HSS Journal ® / Issue 2/2016
Print ISSN: 1556-3316
Electronic ISSN: 1556-3324
DOI
https://doi.org/10.1007/s11420-015-9480-6

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