Articles | Volume 11, issue 1
https://doi.org/10.5194/jbji-11-15-2026
https://doi.org/10.5194/jbji-11-15-2026
Brief report
 | 
12 Jan 2026
Brief report |  | 12 Jan 2026

Synovial fluid specific gravity as an inexpensive point-of-care test for diagnosing hip and knee periprosthetic joint infection

Sujeesh Sebastian, Hibah A. Abusulaiman, Veronika Achatz, Matteo Spadini, Jennyfer A. Mitterer, Sebastian Simon, and Jochen G. Hofstaetter

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Cited articles

Akhbari, P., Jaggard, M. K., Boulangé, C. L., Vaghela, U., Graça, G., Bhattacharya, R., Lindon, J. C., Williams, H. R. T., and Gupte, C. M.: Differences between Infected and Noninfected Synovial Fluid: An Observational Study Using Metabolic Phenotyping (or “metabonomics”), Bone Joint. Research, 10, 85–95, https://doi.org/10.1302/2046-3758.101.BJR-2020-0285.R1, 2021. 
Amanatullah, D. F., Cheng, R. Z., Huddleston, J. I. I., Maloney, W. J., Finlay, A. K., Kappagoda, S., Suh, G. A., and Goodman, S. B.: The routine use of synovial alpha-defensin is not necessary, Bone. Joint. J., 102-B, 593–599, https://doi.org/10.1302/0301-620X.102B5.BJJ-2019-0473.R3, 2020. 
de Paula Mozella, A., Alexandre de Araujo Barros Cobra, H., Monteiro da Palma, I., Salim, R., Antonio Matheus Guimarães, J., Costa, G., and Carolina Leal, A.: Synovial fluid NMR-based metabolomics in septic and aseptic revision total knee arthroplasty: Implications on diagnosis and treatment, J. Orthop. Res., 42, 2336–2344, https://doi.org/10.1002/JOR.25870, 2024. 
Faryna, A. and Goldenberg, K.: Joint Fluid, in: Clinical Methods: The History, Physical, and Laboratory Examinations, edited by: Walker, H. K., Hall, W. D., and Hurst, J. W., Butterworths, Boston, USA, 773–776, https://www.ncbi.nlm.nih.gov/books/NBK274/ (last access: 27 October 2025), 1990. 
Fu, J., Ni, M., Chai, W., Li, X., Hao, L., and Chen, J.: Synovial Fluid Viscosity Test is Promising for the Diagnosis of Periprosthetic Joint Infection, J. Arthroplasty, 34, 1197–1200, https://doi.org/10.1016/j.arth.2019.02.009, 2019. 
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Short summary
A simple, rapid, and low-cost test measuring synovial fluid specific gravity shows high accuracy and excellent specificity for diagnosing hip and knee periprosthetic joint infection. This method can quickly help rule in infections during revision surgeries, making it a practical point-of-care tool, especially in clinics or hospitals with limited resources. Its performance supports use alongside established lab markers for better patient outcomes.
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