How are prosthetic joint infections (PJIs) evaluated for septic arthritis?

Updated: Oct 02, 2020
  • Author: John L Brusch, MD, FACP; Chief Editor: Michael Stuart Bronze, MD  more...
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Evaluation of a possibly infected prosthetic joint is similar to that of a natural joint. [2, 29, 28] The presence of leukocytes in the aspirated fluid is variable. Because many of the potential pathogens are also classic contaminating organisms (eg, coagulase-negative S aureus [CoNS], Propionibacterium species, Corynebacterium species), repeat aspirates are often required to confirm the diagnosis. The use of multiple types of media with prolonged incubation times may increase both the sensitivity and specificity of the culture in prosthetic joint infection. The sensitivity of periprosthetic-tissue culture ranges from 65% to 94%. [27] Material from fistulous tracts is associated with a high rate of contamination and is probably best avoided.

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