TY - JOUR
T1 - Identifying predictive factors of pediatric septic arthritis of the knee in a lyme endemic area
AU - Gage, Mark J.
AU - Twomey, Kristin D.
AU - Sala, Debra A.
AU - Maguire, Kathleen J.
AU - Hanstein, Regina
AU - Hennrikus, William L.
AU - Otsuka, Norman Y.
N1 - Publisher Copyright:
© 2018, J. Michael Ryan Publishing Inc. All rights reserved.
PY - 2018/9
Y1 - 2018/9
N2 - Background: Septic arthritis of the knee in the pediatric patient is a diagnosis that requires prompt identification and treatment. The purpose of this study was to identify clinical and laboratory parameters that allow differential diagnosis of septic arthritis from non-septic arthritis in children. Methods: Fifty-four pediatric patients with atraumatic isolated knee pain were retrospectively identified at three institutions and diagnosed with septic arthritis (SA, N = 28), Lyme arthritis (LA, N = 11), or transient synovitis (TS, N = 15). Clinical and laboratory data were analyzed to identify which factors were most predictive of SA of the knee. Results: Fever at time of presentation, a negative anti-streptolysin-O (ASO), erythrocyte sedimentation rate (ESR) > 40 mm/hr, and C-reactive protein (CRP) > 20 mg/L were the most predictive factors for distinguishing between septic arthritis (SA) and non-septic arthritis (transient synovitis or Lyme arthritis). Elevated ESR and CRP were both significantly higher in patients with SA when compared to TS or LA. Conclusion: When evaluating children with atraumatic isolated knee pain, a combination of the above factors should be utilized when ruling out septic arthritis.
AB - Background: Septic arthritis of the knee in the pediatric patient is a diagnosis that requires prompt identification and treatment. The purpose of this study was to identify clinical and laboratory parameters that allow differential diagnosis of septic arthritis from non-septic arthritis in children. Methods: Fifty-four pediatric patients with atraumatic isolated knee pain were retrospectively identified at three institutions and diagnosed with septic arthritis (SA, N = 28), Lyme arthritis (LA, N = 11), or transient synovitis (TS, N = 15). Clinical and laboratory data were analyzed to identify which factors were most predictive of SA of the knee. Results: Fever at time of presentation, a negative anti-streptolysin-O (ASO), erythrocyte sedimentation rate (ESR) > 40 mm/hr, and C-reactive protein (CRP) > 20 mg/L were the most predictive factors for distinguishing between septic arthritis (SA) and non-septic arthritis (transient synovitis or Lyme arthritis). Elevated ESR and CRP were both significantly higher in patients with SA when compared to TS or LA. Conclusion: When evaluating children with atraumatic isolated knee pain, a combination of the above factors should be utilized when ruling out septic arthritis.
UR - http://www.scopus.com/inward/record.url?scp=85052389115&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85052389115&partnerID=8YFLogxK
M3 - Article
C2 - 31513518
AN - SCOPUS:85052389115
SN - 2328-4633
VL - 76
SP - 161
EP - 164
JO - Bulletin of the Hospital for Joint Diseases
JF - Bulletin of the Hospital for Joint Diseases
IS - 3
ER -