Which lab tests may be useful in the evaluation of septic arthritis?

Updated: Oct 02, 2020
  • Author: John L Brusch, MD, FACP; Chief Editor: Michael Stuart Bronze, MD  more...
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The fluid of an infected bursa closely resembles that of a bacterial joint infection. [19]

An elevated erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP) is useful in following response to therapy, as well as in detecting an acute process in chronically affected joints. Serum procalcitonin may be a more useful biomarker of joint infection than C-reactive protein or white blood cell (WBC) counts. [30]

Measurement of serum uric acid levels cannot be used to establish or negate the diagnosis of uric acid arthropathy. Values may range widely during an acute attack.

Appropriate serologic tests for the diagnosis of various vasculitides or rheumatologic disorders are often indicated. [31]

Obtaining a biopsy of the synovium may be necessary to diagnose one of the many causes (ie, mycobacterial, fungal) of granulomatous synovitis. Examining the synovium histologically often establishes a diagnosis of fungal or mycobacterial joint infections.

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