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Journal of Bone and Joint Infection An open-access journal of the European Bone and Joint Infection Society and the MusculoSkeletal Infection Society
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Volume 4, issue 4
J. Bone Joint Infect., 4, 167–173, 2019
https://doi.org/10.7150/jbji.34854
© Author(s) 2019. This work is distributed under
the Creative Commons Attribution 4.0 License.
J. Bone Joint Infect., 4, 167–173, 2019
https://doi.org/10.7150/jbji.34854
© Author(s) 2019. This work is distributed under
the Creative Commons Attribution 4.0 License.

Review 02 Aug 2019

Review | 02 Aug 2019

Factors to Consider When Assessing the Diagnostic Accuracy of Synovial Leukocyte Count in Periprosthetic Joint Infection

Karsten D Ottink1, Carol Strahm2, Anneke Muller-Kobold3, Parham Sendi4,5,6, and Marjan Wouthuyzen-Bakker7 Karsten D Ottink et al.
  • 1Department of Orthopaedics, University of Groningen, University Medical Centre Groningen, the Netherlands
  • 2Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, Switzerland
  • 3Department of Laboratory Medicine, University of Groningen, University Medical Centre Groningen, The Netherlands
  • 4Department of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University Basel, Basel, Switzerland
  • 5Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland.
  • 6Institute for Infectious Diseases, University of Bern, Bern, Switzerland.
  • 7Department of Medical Microbiology and Infection Prevention, University of Groningen, University Medical Centre Groningen, The Netherlands

Keywords: periprosthetic joint infection, synovial fluid, diagnosis, white blood cell count, polymorphonuclear percentage

Abstract. Synovial white blood cell (WBC) count and the percentage of polymorphonuclear leucocytes (PMN%) is one of the diagnostic criteria to diagnose a periprosthetic joint infection (PJI). Although the test is widely available, the diagnostic accuracy of proposed cut-off levels are influenced by several factors, such as: the affected joint, co-morbid conditions, the causative microorganism and the gathering and processing of samples in the laboratory. In this narrative review we provide an overview on how and to what extent these factors can affect the synovial WBC count and PMN% in synovial fluid.

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