Assessment and diagnosis of the acute hot joint: a systematic review and meta-analysis
Authors' conclusion
Our review demonstrates many single tests, individually with diagnostic utility but suboptimal accuracy for exclusion of native joint infection.
Study context
- Population
- Acute native hot joints; differentiating septic arthritis (SA) from non-septic joints49 articles included
- Comparison
- Serum and synovial fluid (SF) tests vs clinical assessment and SF microscopy and culture for differentiating septic from non-septic acute hot joints
- Outcome
- Diagnostic accuracy (sensitivity, specificity, PPV/NPV, likelihood ratios) of serum and SF tests for differentiating SA from non-septic joints
Methodological detailsbivariate random-effects meta-analysis, English-language articles only, no date restriction
- Bivariate random-effects meta-analysis
- English-language articles only
- No date restriction
Pooled result
As reported in the abstract
Pooled diagnostic accuracy for septic vs non-septic joints (meta-analysis possible for 8 SF tests)
| Group | Pooled sensitivity | Pooled specificity |
|---|---|---|
| Leucocyte esterase | 0.94 (0.70, 0.99) | 0.74 (0.67, 0.81) |
Leucocyte esterase
Pooled sensitivity0.94 (0.70, 0.99)
Pooled specificity0.74 (0.67, 0.81)
Further pooled results
Markers identified
- Distinct markers in SF and serum
- 28
- Serum markers (across thresholds)
- 27
- SF markers (across thresholds)
- 156
Original publication
Assessment and diagnosis of the acute hot joint: a systematic review and meta-analysis. Rheumatology (Oxford). Published 20 October 2022. doi:10.
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