Native vertebral osteomyelitis, a spinal bone infection, is difficult to diagnose, and delays can worsen outcomes. This review examines how traditional laboratory tests and newer genetic techniques can be integrated to improve identification of the responsible microorganism. We show that combining these approaches within the diagnostic pathway may increase accuracy and support earlier diagnosis, enabling more timely and informed treatment decisions.

In Lyme-endemic regions, Lyme disease should be considered in culture-negative periprosthetic joint infection (PJI). Diagnosis relies on microbial DNA detection, particularly Borrelia-targeted polymerase chain reaction (PCR) on synovial fluid or tissue. We present 10 cases highlighting the value of PCR for early recognition of this pathogen, which is not detectable by conventional culture media. Surgical debridement remains the standard of care, though several cases were successfully treated medically, an observation that merits further investigation.

This is a case report which follows a patient who received multiple false positive synovial alpha-defensin test results following a revision for total knee arthroplasty. The report looks at the importance of generalizability in diagnostic testing and how a lack thereof can extend the cost and duration of care.

Our 10-year multicenter study examines the epidemiology, presentation, management, and outcomes of elbow native joint septic arthritis, a rare condition with risks like reoperation and mortality. Common symptoms included pain and swelling. Synovial fluid white blood cell counts were often low, with monosodium urate crystals also noted. Staphylococcus aureus was the main pathogen, and 72.2 % of patients underwent open debridement.

This retrospective case-matched study evaluated males and females with staphylococcal PJI (periprosthetic joint infection) treated with two-stage exchange arthroplasty. We matched 156 males and females for age, type of staphylococcal infection, and joint involved. We compared clinical parameters related to presentation, treatment, and outcome. We did not find a statistically significant difference in outcome between males and females treated with the same surgical approach at our institution.