Articles | Volume 11, issue 3
https://doi.org/10.5194/jbji-11-287-2026
https://doi.org/10.5194/jbji-11-287-2026
Original full-length article
 | 
19 May 2026
Original full-length article |  | 19 May 2026

Can we identify which patients are likely to have septic arthritis with borderline synovial fluid cell counts?

Boshen Liu, Michael Raffetto, Eric J. Abbenhaus, Gavin S. Hautala, William R. Taylor, Lucy Bowers, and Paul Edward Matuszewski

Cited articles

Carpenter, C. R., Schuur, J. D., Everett, W. W., and Pines, J. M.: Evidence-based diagnostics: adult septic arthritis, Acad. Emerg. Med., 18, 781–796, https://doi.org/10.1111/j.1553-2712.2011.01121.x, 2011. 
Coutlakis, P. J., Roberts, W. N., and Wise, C. M.: Another look at synovial fluid leukocytosis and infection, J. Clin. Rheumatol., 8, 67–71, https://doi.org/10.1097/00124743-200204000-00001, 2002. 
Edwards, C. J., Cooper, C., Fisher, D., Field, M., van Staa, T. P., and Arden, N. K.: The importance of the disease process and disease-modifying antirheumatic drug treatment in the development of septic arthritis in patients with rheumatoid arthritis, Arthritis Rheumatol., 57, 1151–1157, https://doi.org/10.1002/art.23003, 2007. 
Ferrand, J., Samad, Y. E., Brunschweiler, B., Grados, F., Dehamchia-Rehailia, N., Séjourne, A., Schmit, J.-L., Gabrion, A., Fardellone, P., and Paccou, J.: Morbimortality in adult patients with septic arthritis: a three-year hospital-based study, BMC Infect. Dis., 16, 239–239, https://doi.org/10.1186/s12879-016-1540-0, 2016. 
Gupta, M. N., Sturrock, R. D., and Field, M.: Prospective comparative study of patients with culture proven and high suspicion of adult onset septic arthritis, Ann. Rheum. Dis., 62, 327–331, https://doi.org/10.1136/ard.62.4.327, 2003. 
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Short summary
This study aims to identify characteristics associated with septic arthritis in patients who have inconclusive laboratory findings. This would potentially allow for improved ability to identify a pathology that can be marked by ambiguity.  

We found three characteristics associated with increased risk of septic arthritis. Additionally, we found that lowering historic thresholds may be appropriate in order to prevent missed or delayed diagnosis of a pathology with considerable morbidity.

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