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Serum Procalcitonin is a sensitive and specific marker in the diagnosis of septic arthritis and acute osteomyelitis

BACKGROUND: Early diagnosis of Acute Osteomyelitis (OM) and Septic Arthritis (SA) is of vital importance to avoid devastating complications. There is no single laboratory marker which is sensitive and specific in diagnosing these infections accurately. Total Count, ESR and CRP are not specific as th...

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Autores principales: Maharajan, Karthikeyan, Patro, Dilip Kumar, Menon, Jagdish, Hariharan, Ananthanarayanan Palghat, Parija, Sabhash Chandra, Poduval, Murali, Thimmaiah, Sreenivas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3718669/
https://www.ncbi.nlm.nih.gov/pubmed/23826894
http://dx.doi.org/10.1186/1749-799X-8-19
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author Maharajan, Karthikeyan
Patro, Dilip Kumar
Menon, Jagdish
Hariharan, Ananthanarayanan Palghat
Parija, Sabhash Chandra
Poduval, Murali
Thimmaiah, Sreenivas
author_facet Maharajan, Karthikeyan
Patro, Dilip Kumar
Menon, Jagdish
Hariharan, Ananthanarayanan Palghat
Parija, Sabhash Chandra
Poduval, Murali
Thimmaiah, Sreenivas
author_sort Maharajan, Karthikeyan
collection PubMed
description BACKGROUND: Early diagnosis of Acute Osteomyelitis (OM) and Septic Arthritis (SA) is of vital importance to avoid devastating complications. There is no single laboratory marker which is sensitive and specific in diagnosing these infections accurately. Total Count, ESR and CRP are not specific as they can also be elevated in non pyogenic causes of inflammation. Pus Culture and sensitivity is not a true gold standard due to its varied positivity rates (40 – 70%). Serum Procalcitonin (PCT), at 0.5 ng/ml is found to be an accurate marker for pyogenic infections. The objectives of this study were to show that PCT is an accurate marker in differentiating Acute Osteomyelitis and Septic Arthritis from viral and non infective inflammatory bone and joint conditions. METHODS: Patients of all age groups (n = 82) with suspected Acute Osteomyelitis and Septic Arthritis were prospectively included in this study. All patients were subjected to TC, CRP, PCT, IgM Dengue, IgM Chikungunya, pus and blood culture and sensitivity. At the end of the study, patients were classified into 3 groups: Group 1 = Confirmed Pyogenic (n = 27); Group 2 = Presumed Pyogenic (n = 21); Group 3 = Non – infective inflammatory (n = 34). RESULTS: Group 1 has higher mean PCT levels than Group 2 and 3 (p < 0.05). PCT, at 0.4 ng/ml, was 85.2% sensitive and 87.3% specific in diagnosing Septic Arthritis and Acute Osteomyelitis. In comparison, PCT at conventional cut – off of 0.5 ng/ml is 66.7% sensitive and 91% specific. CONCLUSION: Serum Procalcitonin, at a cut – off of 0.4 ng/ml, is a sensitive and specific marker in the diagnosis of Septic Arthritis and Acute Osteomyelitis.
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spelling pubmed-37186692013-07-23 Serum Procalcitonin is a sensitive and specific marker in the diagnosis of septic arthritis and acute osteomyelitis Maharajan, Karthikeyan Patro, Dilip Kumar Menon, Jagdish Hariharan, Ananthanarayanan Palghat Parija, Sabhash Chandra Poduval, Murali Thimmaiah, Sreenivas J Orthop Surg Res Research Article BACKGROUND: Early diagnosis of Acute Osteomyelitis (OM) and Septic Arthritis (SA) is of vital importance to avoid devastating complications. There is no single laboratory marker which is sensitive and specific in diagnosing these infections accurately. Total Count, ESR and CRP are not specific as they can also be elevated in non pyogenic causes of inflammation. Pus Culture and sensitivity is not a true gold standard due to its varied positivity rates (40 – 70%). Serum Procalcitonin (PCT), at 0.5 ng/ml is found to be an accurate marker for pyogenic infections. The objectives of this study were to show that PCT is an accurate marker in differentiating Acute Osteomyelitis and Septic Arthritis from viral and non infective inflammatory bone and joint conditions. METHODS: Patients of all age groups (n = 82) with suspected Acute Osteomyelitis and Septic Arthritis were prospectively included in this study. All patients were subjected to TC, CRP, PCT, IgM Dengue, IgM Chikungunya, pus and blood culture and sensitivity. At the end of the study, patients were classified into 3 groups: Group 1 = Confirmed Pyogenic (n = 27); Group 2 = Presumed Pyogenic (n = 21); Group 3 = Non – infective inflammatory (n = 34). RESULTS: Group 1 has higher mean PCT levels than Group 2 and 3 (p < 0.05). PCT, at 0.4 ng/ml, was 85.2% sensitive and 87.3% specific in diagnosing Septic Arthritis and Acute Osteomyelitis. In comparison, PCT at conventional cut – off of 0.5 ng/ml is 66.7% sensitive and 91% specific. CONCLUSION: Serum Procalcitonin, at a cut – off of 0.4 ng/ml, is a sensitive and specific marker in the diagnosis of Septic Arthritis and Acute Osteomyelitis. BioMed Central 2013-07-04 /pmc/articles/PMC3718669/ /pubmed/23826894 http://dx.doi.org/10.1186/1749-799X-8-19 Text en Copyright © 2013 Karthikeyan et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Maharajan, Karthikeyan
Patro, Dilip Kumar
Menon, Jagdish
Hariharan, Ananthanarayanan Palghat
Parija, Sabhash Chandra
Poduval, Murali
Thimmaiah, Sreenivas
Serum Procalcitonin is a sensitive and specific marker in the diagnosis of septic arthritis and acute osteomyelitis
title Serum Procalcitonin is a sensitive and specific marker in the diagnosis of septic arthritis and acute osteomyelitis
title_full Serum Procalcitonin is a sensitive and specific marker in the diagnosis of septic arthritis and acute osteomyelitis
title_fullStr Serum Procalcitonin is a sensitive and specific marker in the diagnosis of septic arthritis and acute osteomyelitis
title_full_unstemmed Serum Procalcitonin is a sensitive and specific marker in the diagnosis of septic arthritis and acute osteomyelitis
title_short Serum Procalcitonin is a sensitive and specific marker in the diagnosis of septic arthritis and acute osteomyelitis
title_sort serum procalcitonin is a sensitive and specific marker in the diagnosis of septic arthritis and acute osteomyelitis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3718669/
https://www.ncbi.nlm.nih.gov/pubmed/23826894
http://dx.doi.org/10.1186/1749-799X-8-19
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