Identifying predictive factors of pediatric septic arthritis of the knee in a lyme endemic area

Mark J. Gage, Kristin D. Twomey, Debra A. Sala, Kathleen J. Maguire, Regina Hanstein, William L. Hennrikus, Norman Y. Otsuka

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)161-164
Number of pages4
JournalBulletin of the Hospital for Joint Diseases
Volume76
Issue number3
StatePublished - Sep 1 2018
Externally publishedYes

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Infectious Arthritis
Knee
Pediatrics
Synovitis
Lyme Disease
Blood Sedimentation
C-Reactive Protein
Arthritis
Pain
Differential Diagnosis
Fever

ASJC Scopus subject areas

  • Surgery
  • Rheumatology
  • Orthopedics and Sports Medicine

Cite this

Gage, M. J., Twomey, K. D., Sala, D. A., Maguire, K. J., Hanstein, R., Hennrikus, W. L., & Otsuka, N. Y. (2018). Identifying predictive factors of pediatric septic arthritis of the knee in a lyme endemic area. Bulletin of the Hospital for Joint Diseases, 76(3), 161-164.

Identifying predictive factors of pediatric septic arthritis of the knee in a lyme endemic area. / Gage, Mark J.; Twomey, Kristin D.; Sala, Debra A.; Maguire, Kathleen J.; Hanstein, Regina; Hennrikus, William L.; Otsuka, Norman Y.

In: Bulletin of the Hospital for Joint Diseases, Vol. 76, No. 3, 01.09.2018, p. 161-164.

Research output: Contribution to journalArticle

Gage, MJ, Twomey, KD, Sala, DA, Maguire, KJ, Hanstein, R, Hennrikus, WL & Otsuka, NY 2018, 'Identifying predictive factors of pediatric septic arthritis of the knee in a lyme endemic area', Bulletin of the Hospital for Joint Diseases, vol. 76, no. 3, pp. 161-164.
Gage MJ, Twomey KD, Sala DA, Maguire KJ, Hanstein R, Hennrikus WL et al. Identifying predictive factors of pediatric septic arthritis of the knee in a lyme endemic area. Bulletin of the Hospital for Joint Diseases. 2018 Sep 1;76(3):161-164.
Gage, Mark J. ; Twomey, Kristin D. ; Sala, Debra A. ; Maguire, Kathleen J. ; Hanstein, Regina ; Hennrikus, William L. ; Otsuka, Norman Y. / Identifying predictive factors of pediatric septic arthritis of the knee in a lyme endemic area. In: Bulletin of the Hospital for Joint Diseases. 2018 ; Vol. 76, No. 3. pp. 161-164.
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