{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T05:18:10Z","timestamp":1790831890882,"version":"4.1.0"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2015,3,30]],"date-time":"2015-03-30T00:00:00Z","timestamp":1427673600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CJEM"],"published-print":{"date-parts":[[2015,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S1481803514000566_abs1\" sec-type=\"general\"><jats:title>Objective<\/jats:title><jats:p>To determine the sensitivity and specificity of clinical and laboratory signs for the diagnosis of septic arthritis (SA).<\/jats:p><\/jats:sec><jats:sec id=\"S1481803514000566_abs2\" sec-type=\"general\"><jats:title>Patients and methods<\/jats:title><jats:p>This prospective study included all adult patients with suspected SA seen in the emergency department or rheumatology department at the University Hospital, Clermont-Ferrand, France, over a period of 18 months.<\/jats:p><\/jats:sec><jats:sec id=\"S1481803514000566_abs3\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>In total, 105 patients with suspected SA were included, 38 (36%) presenting with SA (29 [28%] with bacteriologically documented SA). In the univariate analysis, chills (<jats:italic>p<\/jats:italic>=0.015), gradual onset (<jats:italic>p<\/jats:italic>=0.04), local redness (<jats:italic>p<\/jats:italic>=0.01), as well as an entry site for infection (<jats:italic>p<\/jats:italic>=0.01) were most often identified in SA. A history of crystal-induced arthritis (<jats:italic>p<\/jats:italic>=0.004) was more frequent in non-SA cases. An erythrocyte sedimentation rate (ESR)&gt;50 mm (<jats:italic>p<\/jats:italic>=0.005), a C-reactive protein (CRP) level &gt;100 mg\/L (<jats:italic>p<\/jats:italic>=0.019), and radiological signs suggestive of SA (<jats:italic>p<\/jats:italic>=0.001) were more frequent in the SA cases. Synovial fluid appearance: purulent (<jats:italic>p<\/jats:italic>&lt;0.001) and clear (<jats:italic>p<\/jats:italic>=0.007), synovial white blood cell (WBC) count &gt;50,000\/\u03bcL (<jats:italic>p<\/jats:italic> &lt; 0.001), differentiated between SA and non-SA.<\/jats:p><jats:p>In multivariate analysis, only chills (odds ration [OR]=4.7, 95% confidence interval [CI] 1.3\u201317.1), a history of crystal-induced arthritis (OR=0.09, 95% CI 0.01\u20130.9), purulent appearance of the joint fluid (OR=8.4, 95% CI 2.4\u201328.5), synovial WBC count &gt;50,000\/mm<jats:sup>3<\/jats:sup> (OR=6.8, 95% CI 1.3\u201336), and radiological findings (OR=7.1, 95% CI 13\u201337.9) remained significant.<\/jats:p><\/jats:sec><jats:sec id=\"S1481803514000566_abs4\" sec-type=\"conclusion\"><jats:title>Conclusion<\/jats:title><jats:p>No clinical sign or laboratory test (excluding bacteriological test), taken alone, is conclusive for the differentiation between SA and non-SA, but the association of several signs, notably chills, history of crystal-induced arthritis, radiological findings, and the appearance and cellularity of joint fluid may be suggestive.<\/jats:p><\/jats:sec>","DOI":"10.1017\/cem.2014.56","type":"journal-article","created":{"date-parts":[[2015,3,30]],"date-time":"2015-03-30T17:14:13Z","timestamp":1427735653000},"page":"403-410","source":"Crossref","is-referenced-by-count":36,"title":["Predictive value of the usual clinical signs and laboratory tests in the diagnosis of septic arthritis"],"prefix":"10.1007","volume":"17","author":[{"given":"Marion","family":"Couderc","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Pereira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvain","family":"Mathieu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeannot","family":"Schmidt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Lesens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Bonnet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Soubrier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Jacques","family":"Dubost","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2015,3,30]]},"reference":[{"key":"S1481803514000566_ref19","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-012-2363-y"},{"key":"S1481803514000566_ref1","first-page":"11","article-title":"Pyogenic arthritis in adults","volume":"67","author":"Dubost","year":"2000","journal-title":"Joint Bone Spine"},{"key":"S1481803514000566_ref11","doi-asserted-by":"publisher","DOI":"10.1136\/emj.2006.037929"},{"key":"S1481803514000566_ref3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbspin.2011.04.019"},{"key":"S1481803514000566_ref4","doi-asserted-by":"publisher","DOI":"10.1111\/j.1553-2712.2011.01121.x"},{"key":"S1481803514000566_ref9","doi-asserted-by":"publisher","DOI":"10.2307\/2531595"},{"key":"S1481803514000566_ref7","volume-title":"Applied logistic regression","author":"Hosmer","year":"1989"},{"key":"S1481803514000566_ref12","doi-asserted-by":"publisher","DOI":"10.1097\/SMJ.0b013e3181ddd246"},{"key":"S1481803514000566_ref14","doi-asserted-by":"publisher","DOI":"10.1136\/ard.56.8.470"},{"key":"S1481803514000566_ref5","doi-asserted-by":"publisher","DOI":"10.1080\/03610919708813397"},{"key":"S1481803514000566_ref16","doi-asserted-by":"publisher","DOI":"10.1136\/ard.62.4.327"},{"key":"S1481803514000566_ref8","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0258(20000430)19:8<1059::AID-SIM412>3.0.CO;2-0"},{"key":"S1481803514000566_ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2010.05.029"},{"key":"S1481803514000566_ref10","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780381215"},{"key":"S1481803514000566_ref17","doi-asserted-by":"publisher","DOI":"10.1097\/00005792-199309000-00002"},{"key":"S1481803514000566_ref2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.297.13.1478"},{"key":"S1481803514000566_ref13","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.110368"},{"key":"S1481803514000566_ref6","unstructured":"Shtatland ES , Cain E , Barton MB. 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