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The potential use of microcalorimetry in rapid differentiation between septic arthritis and other causes of arthritis

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Abstract

Current diagnostic methods in differentiating septic from non-septic arthritis are time-consuming (culture) or have limited sensitivity (Gram stain). Microcalorimetry is a novel method that can rapidly detect microorganisms by their heat production. We investigated the accuracy and time to detection of septic arthritis by using microcalorimetry. Patients older than 18 years of age with acute arthritis of native joints were prospectively included. Synovial fluid was aspirated and investigated by Gram stain, culture and microcalorimetry. The diagnosis of septic arthritis and non-septic arthritis were made by experienced rheumatologists or orthopaedic surgeons. Septic arthritis was diagnosed by considering the finding of acute arthritis together with findings such as positive Gram stain or positive culture of synovial fluid or positive blood culture. The sensitivity and specificity for diagnosing septic arthritis and the time to positivity of microcalorimetry were determined. Of 90 patients (mean age 64 years), nine had septic arthritis, of whom four (44 %) had positive Gram stain, six (67 %) positive synovial fluid culture and four (44 %) had positive blood culture. The sensitivity of microcalorimetry was 89 %, the specificity was 99 % and the mean detection time was 5.0 h (range, 2.2–8.0 h). Microcalorimetry is an accurate and rapid method for the diagnosis of septic arthritis. It has potential to be used in clinical practice in diagnosing septic arthritis.

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The authors declare that they do not have any conflict of interest.

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Author notes

  1. E. Yusuf

    Present address: Department of Medical Microbiology and Infection Control, UZ Brussel, Laarbeeklaan 101, 1210, Brussels, Belgium

  2. A. Trampuz

    Present address: Center for Musculoskeletal Surgery, Charité, University Medicine, Free and Humboldt-University of Berlin, Berlin, Germany

Authors and Affiliations

  1. Infectious Diseases Service, Department of Medicine, University Hospital, Lausanne, Switzerland

    E. Yusuf, C. Voide & A. Trampuz

  2. Division of Rheumatology, Department of Internal Medicine, University Hospital, Basel, Switzerland

    T. Hügle & T. Daikeler

  3. Orthopaedic Septic Surgical Unit, Department of Surgery and Anaesthesiology, University Hospital, Lausanne, Switzerland

    O. Borens

Authors
  1. E. Yusuf
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  2. T. Hügle
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  3. T. Daikeler
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  4. C. Voide
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  5. O. Borens
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  6. A. Trampuz
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Correspondence to E. Yusuf.

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Yusuf, E., Hügle, T., Daikeler, T. et al. The potential use of microcalorimetry in rapid differentiation between septic arthritis and other causes of arthritis. Eur J Clin Microbiol Infect Dis 34, 461–465 (2015). https://doi.org/10.1007/s10096-014-2248-y

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  • DOI: https://doi.org/10.1007/s10096-014-2248-y

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