308 results match your criteria Arthrocentesis Knee

Synovial Fluid and Serum Neutrophil-to-Lymphocyte Ratio: Novel Biomarkers for the Diagnosis and Prognosis of Native Septic Arthritis in Adults.

J Bone Joint Surg Am 2022 Jun 20. Epub 2022 Jun 20.

Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.

Background: Septic arthritis (SA) is a musculoskeletal emergency for which prompt diagnosis and treatment are critical. However, traditional diagnostic criteria of a synovial fluid (SF) white blood-cell count (WBC) of >50,000 cells/mm3 or >90% polymorphonuclear leukocytes (%PMN) are not particularly sensitive or specific for the diagnosis of SA. Furthermore, prognostic markers are lacking. Read More

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Comparison of knee arthrocentesis first-attempt success between Ultrasound-Guided, Ultrasound-Localised and Landmark-Guided techniques in the novice: A crossover study with random order of events.

Australas J Ultrasound Med 2022 May 26;25(2):74-79. Epub 2022 Apr 26.

Cooper University Hospital Camden New Jersey USA.

Introduction/purpose: To compare knee arthrocentesis first-attempt success using landmark-guided, ultrasound-localised and ultrasound-guided techniques when performed by third-year medical students.

Methods: In this prospective, crossover study with randomised order of events, medical students performed three different arthrocentesis techniques on knee models: landmark-guided, ultrasound-localised and ultrasound-guided. Each subject attempted the techniques in a randomly assigned permutation at both high- and low-volume simulated knee effusions. Read More

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Lumbar osteomyelitis and knee septic arthritis caused by bacteraemia.

BMJ Case Rep 2022 Apr 19;15(4). Epub 2022 Apr 19.

Department of Medicine, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA

A man in his late 70s presented to the emergency department endorsing a week of malaise. He was recently hospitalised for 2 days for new back pain and was discharged with non-opioid pain medications but continued to seek care as he felt unwell. On presentation, he was afebrile with a leukocytosis. Read More

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Mastery versus invention learning: impacts on future learning of simulated procedural skills.

Adv Health Sci Educ Theory Pract 2022 May 23;27(2):441-456. Epub 2022 Mar 23.

Department of Family Medicine, McMaster University, Hamilton, Canada.

Background: Invention and mastery learning approaches differ in their foundational educational paradigms, proposed mechanisms of learning, and potential impacts on learning outcomes. They also differ in their resource requirements. We explored the relative effects of 'invent and problem-solve, followed by instruction' (PS-I) learning compared to mastery learning (i. Read More

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Knee Arthrocentesis in Adults.

J Vis Exp 2022 02 25(180). Epub 2022 Feb 25.

Department of Medicine, BronxCare Health System.

Arthrocentesis of the knee is a procedure in which a needle is inserted into the knee joint, and synovial fluid is aspirated. An arthrocentesis can be diagnostic or therapeutic. Synovial fluid may be removed for testing to determine the nature of the knee effusion. Read More

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February 2022

Scurvy: a rare cause of haemarthrosis.

BMJ Case Rep 2022 Mar 7;15(3). Epub 2022 Mar 7.

Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas, USA

A male in his 60s with a history of previously treated locally advanced head and neck cancer presented to the emergency department with atraumatic left knee pain and upper and lower extremity ecchymoses that had been present for 3 weeks. His initial laboratory results showed a normocytic anaemia, normal platelet count, slightly abnormal coagulation studies and normal inflammatory markers. Arthrocentesis of the left knee revealed haemarthrosis, and additional laboratory workup found an undetectable serum vitamin C (ascorbic acid) level consistent with scurvy. Read More

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Recent Antibiotic Treatment Impacts Serum and Synovial Laboratory Values in Early Periprosthetic Joint Infection Workup.

J Arthroplasty 2022 06 22;37(6S):S286-S290. Epub 2022 Feb 22.

Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.

Background: Accurately detecting early postoperative periprosthetic joint infection (PJI) following total hip arthroplasty (THA) and total knee arthroplasty (TKA) remains challenging. The purpose of our study was to determine the impact of antibiotics given prior to laboratory evaluation on the reliability of serologic and synovial fluid tests to identify PJI in the early postoperative period.

Methods: We identified 49,861 primary total hip arthroplasties and total knee arthroplasties performed between 2000 and 2019. Read More

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Common bacteria and treatment options for the acute and chronic infection of the total ankle arthroplasty.

Foot Ankle Surg 2022 Feb 18. Epub 2022 Feb 18.

Schön Klinik München Harlaching - FIFA Medical Centre, 81547 Munich, Germany.

Background: There is little valid data available on managing infected total ankle arthroplasty (TAA).

Methods: A single-center, retrospective evaluation from 20 patients with PJI (periprosthetic joint infection) of the ankle compared the bacteria isolated by preoperative arthrocentesis and intraoperative cultures to the pathogens of knee PJI. Long-term failure rates of irrigation and debridement (I&D) and polyethylene exchange, revision arthroplasty, and arthrodesis were analyzed. Read More

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February 2022

The Value of Thermal Imaging for Knee Arthritis: A Single-Center Observational Study.

Yonsei Med J 2022 Feb;63(2):141-147

Division of Rheumatology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.

Purpose: To compare (non-contact) thermal imaging with power Doppler (PD) for the evaluation of knee arthritis with joint effusion.

Materials And Methods: We enrolled patients with knee arthritis who were scheduled to undergo an arthrocentesis of the knee from April to December 2020 at a single tertiary hospital. A thermography camera, FLIR ONE Pro, was used to obtain both thermographic and digital images on subjects. Read More

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February 2022

Staphylococcus aureus-induced septic arthritis of the ankle related to malum perforans in a diabetes patient.

Rom J Morphol Embryol 2021 Apr-Jun;62(2):615-619

Department of Immunology, Department of Biostatistics, University of Medicine and Pharmacy of Craiova, Romania;

Septic arthritis (SA) is a less common joint pathology with potentially fatal outcome. It is considered a medical emergency, in which prompt diagnosis and differentiation of bacterial etiology is essential for appropriate management. The knee is the most prevalent site for SA (~50% of cases), followed by hip, shoulder, and elbow. Read More

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January 2022

Randomized Controlled Study of a Training Program for Knee and Shoulder Arthrocentesis on Procedural Simulators with Assessment on Cadavers.

ACR Open Rheumatol 2022 Apr 6;4(4):312-321. Epub 2022 Jan 6.

University of Caen Normandy, Caen, France.

Objective: The study objective was to assess the efficacy of simulators in improving the competence of students in performing a knee and shoulder arthrocentesis on cadavers and to determine the minimum number of simulator training procedures needed to achieve competence in arthrocentesis.

Methods: Two groups of 15 medical students were each trained to perform a single joint arthrocentesis ("knee group" and "shoulder group") on a simulator to serve as a control for the other. The two groups received the same theoretical training (anatomy, arthrocentesis techniques, ultrasound, and hybrid simulation). Read More

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Effects of Low-Load Blood-Flow Restricted Resistance Training on Functional Capacity and Patient-Reported Outcome in a Young Male Suffering From Reactive Arthritis.

Front Sports Act Living 2021 20;3:798902. Epub 2021 Dec 20.

Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.

Reactive arthritis (ReA) is a chronic inflammatory disease usually caused by a preceding gastrointestinal or genitourinary bacterial infection. ReA usually occurs in the lower limbs causing joint pain and joint swelling. Physiotherapy-led exercise is recommended to prevent muscle atrophy. Read More

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December 2021

Enhanced arthrocentesis of the effusive knee with pneumatic compression.

Int J Rheum Dis 2022 Mar 4;25(3):303-310. Epub 2022 Jan 4.

Department of Internal Medicine, Division of Rheumatology, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA.

Aim: Complete arthrocentesis of the effusive knee ameliorates patient pain, reduces intra-articular and intraosseous pressure, removes inflammatory cytokines, and has been shown to substantially improve the therapeutic outcomes of intra-articular injections. However, conventional arthrocentesis incompletely decompresses the knee, leaving considerable residual synovial fluid in the intra-articular space. The present study determined whether external pneumatic circumferential compression of the effusive knee permitted more successful arthrocentesis and complete joint decompression. Read More

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A Case of Spinal Infectious Osteomyelitis Versus Gout: Advanced Imaging with Dual Energy CT.

Yale J Biol Med 2021 12 29;94(4):599-602. Epub 2021 Dec 29.

Department of Radiology and Biomedical Imaging, Neuroradiology, Yale Program for Innovation in Imaging Informatics, Yale University School of Medicine, New Haven, CT, USA.

A 67-year-old male presented to the hospital for lower back pain and left lower extremity radiculopathy. Although the patient was afebrile and white blood cell count was normal, MRI was concerning for discitis/osteomyelitis at L4-L5. Subsequently, the patient developed a right knee joint effusion and underwent an arthrocentesis that was notable for the presence of urate crystals. Read More

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December 2021

Synovial-Based Tests Outperform Serum Markers to Rule Out Infection in Total Knee Arthroplasty and Total Hip Arthroplasty: A Systematic Review and Meta-Analysis.

J Arthroplasty 2022 04 21;37(4):802-808.e5. Epub 2021 Dec 21.

Department of Orthopedic Surgery, Diakonessenhuis Utrecht/Zeist, Utrecht, the Netherlands; Clinical Orthopedic Research Center Midden Nederland, Diakonessenhuis Utrecht/Zeist, Zeist, the Netherlands.

Background: Total knee arthroplasty (TKA) provides successful results in most patients. Periprosthetic joint infection (PJI) accounts for up to 25% of failed TKAs needing revision. In clinical practice, consensus in diagnostic strategy for excluding or diagnosing PJI is still lacking. Read More

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Septic Arthritis and Bacteremia Due to Infection by Pasteurella canis.

Cureus 2021 Nov 11;13(11):e19478. Epub 2021 Nov 11.

Clinical Pathology, Hospital Distrital de Santarém, Santarém, PRT.

is a Gram-negative coccobacilli from the family. The most common form of transmission to humans is a bite from a dog or a cat. We report a case of a 90-year-old woman who presented with septic arthritis in the right knee and bacteremia two weeks after a cat bite. Read More

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November 2021

Primary meningococcal septic arthritis associated with joint calcium oxalate crystals: A case report and review of the literature.

Mod Rheumatol Case Rep 2022 06;6(2):296-300

Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.

Primary meningococcal septic arthritis (PMSA) is an extremely rare local infection by Neisseria meningitidis in the absence of meningitis or meningococcaemia syndrome. A 30-year-old healthy, immunocompetent man presented with arthralgia, fever, chest rash, and significant swelling of the right knee. On admission, a disseminated maculopapular and purpuric rash, oligoarthritis, neutrophilia, and elevated acute phase reactants were documented. Read More

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Polymyalgia Rheumatica in a Patient with Pseudogout and Dementia.

Am J Case Rep 2021 Nov 23;22:e933926. Epub 2021 Nov 23.

Department of General Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan.

BACKGROUND The differential diagnosis of generalized pain includes reactivity associated with bacterial and viral infections, autoimmune rheumatic disease, and orthopedic diseases. Obtaining a detailed medical history and establishing an accurate diagnosis are difficult in elderly patients with dementia. In addition, the differential diagnosis between polymyalgia rheumatica and pseudogout is often difficult. Read More

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November 2021

Intra-articular venous malformations of the knee: a diagnostic challenge.

Pediatr Rheumatol Online J 2021 Oct 13;19(1):153. Epub 2021 Oct 13.

UOSD Reumatologia e Immunologia Pediatrica, Ospedale Vito Fazzi, Lecce, Italy.

Background: Intra-articular venous malformations (IAVM) are rare benign vascular anomalies that usually affect young patients and most common locate in the knee. The terminology of these lesions is still ill-defined, as they are often termed in the literature as synovial hemangiomas. Early diagnosis can be difficult, because they usually present with nonspecific clinical manifestations that are similar those of other rheumatic diseases, especially juvenile idiopathic arthritis (JIA). Read More

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October 2021

Adult Native Joint Septic Arthritis: A Nine-Year Retrospective Analysis in a Portuguese University Hospital.

Acta Med Port 2021 Dec 21;34(12):826-832. Epub 2021 Sep 21.

GRIP - Grupo de Infeção Osteoarticular do Porto - Porto Osteoarticular Infection Group. Centro Hospitalar Universitário do Porto. Porto. Serviço de Doenças Infeciosas. Centro Hospitalar Universitário do Porto. Porto. Portugal.

Introduction: Septic arthritis of a native joint represents a medical emergency. Drainage and effective antibiotic treatment are critical to avoid joint destruction and long-term impairment. The aim of this study was to evaluate epidemiological and clinical characteristics of patients with the diagnosis of septic arthritis to help establish local guidelines for empirical antibiotic treatment. Read More

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December 2021

The Feasibility of Ultrasound-Guided Knee Arthrocentesis Training Using Formalin-Embalmed.

JB JS Open Access 2021 Jul-Sep;6(3). Epub 2021 Sep 9.

Rocky Vista University College of Osteopathic Medicine-Southern Utah Campus, Ivins, Utah.

Background: The use of ultrasound guidance during knee arthrocentesis has proven to increase operator confidence and accuracy, particularly in novice healthcare providers. Realistic and practical means of teaching this procedure to medical trainees are needed. This study is intended to assess the feasibility and efficacy of using formalin-embalmed human cadavers in the instruction of ultrasound-guided knee arthrocentesis to medical trainees. Read More

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September 2021

Risk of Severe Acute Localized Reactions for Different Intraarticular Hyaluronic Acid Knee Injections in a Real-World Setting.

Cartilage 2021 12 13;13(1_suppl):376S-386S. Epub 2021 Sep 13.

Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, CA, USA.

Objective: Case reports of severe acute localized reactions (SALR) following intraarticular (IA) hyaluronic acid (HA) injections for knee osteoarthritis (OA) have been described. We compared surrogate SALR measures between patients using hylan G-F 20 and specific non-hylan G-F 20 HA products.

Design: Knee OA patients were identified from the Optum Clinformatics dataset (January 2006 to June 2016), stratified into hylan G-F 20 and non-hylan G-F 20 HA users, matched by single or multiple injection products. Read More

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December 2021

Improving Self-Confidence of Military Medical Providers With Joint Procedure Simulation: A Pilot Study.

Mil Med 2021 Jul 28. Epub 2021 Jul 28.

Department of Rheumatology, Tripler Army Medical Center, Honolulu, HI 96859, USA.

Introduction: Military medical providers are a unique population that encounter different environments across the world. From hospital clinics to war zones, these providers must perform procedures and rely on their training and skill to help their patients. This pilot study aimed to assess the self-confidence of military medical providers performing joint aspiration and injection before and after a simulation workshop in both clinical and austere settings. Read More

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Development and validation of case-finding algorithms to identify prosthetic joint infections after total knee arthroplasty in Veterans Health Administration data.

Pharmacoepidemiol Drug Saf 2021 09 5;30(9):1184-1191. Epub 2021 Jul 5.

Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Purpose: To determine the positive predictive values (PPVs) of ICD-9, ICD-10, and current procedural terminology (CPT)-based diagnostic coding algorithms to identify prosthetic joint infection (PJI) following knee arthroplasty (TKA) within the United States Veterans Health Administration.

Methods: We identified patients with: (1) hospital discharge ICD-9 or ICD-10 diagnosis of PJI, (2) ICD-9, ICD-10, or CPT procedure code for TKA prior to PJI diagnosis, (3) CPT code for knee X-ray within ±90 days of the PJI diagnosis, and (4) at least 1 CPT code for arthrocentesis, arthrotomy, blood culture, or microbiologic procedure within ±90 days of the PJI diagnosis date. Separate samples of patients identified with the ICD-9 and ICD-10-based PJI diagnoses were obtained, stratified by TKA procedure volume at each medical center. Read More

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September 2021

Validation of Septic Knee Monoarthritis Prediction Rule in a Lyme Disease Endemic Area.

Pediatr Emerg Care 2022 Feb;38(2):e881-e885

Division of Emergency Medicine, Boston Children's Hospital, Boston, MA.

Objective: In Lyme disease endemic areas, Lyme and septic arthritis often present similarly. A published septic knee arthritis clinical prediction rule includes 2 high-risk predictors: absolute neutrophil count of 10,000 cells/mm3 or greater and erythrocyte sedimentation rate of 40 mm/h or greater. The objective of the study was to externally validate this prediction rule in a multicenter prospective cohort. Read More

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February 2022

Disseminated Coccidioidomycosis of the Knee Joint Requiring Synovectomy and Arthrotomy.

J Orthop Case Rep 2021 Feb;11(2):76-80

Department of Orthopaedic, Joe R. and Teresa Lozano Long School of Medicine, University of Texas Health at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229.

Introduction: Coccidioidomycosis is a fungal infection endemic to the Southwestern United States, Mexico, and South America. While uncommon, inhalation of spores or direct cutaneous contact can lead to disseminated infection in the immunocompetent, with the involvement of the musculoskeletal and integumentary systems.

Case Report: A 49-year-old patient with a history of pulmonary coccidioidomycosis presented with the right knee pain and multiple symptomatic abscesses beneath the suprapatellar and infrapatellar fat pads. Read More

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February 2021

The effectiveness of laboratory tests to predict early postoperative periprosthetic infection after total knee arthroplasty.

Bone Joint J 2021 Jun;103-B(6 Supple A):177-184

Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA.

Aims: It remains difficult to diagnose early postoperative periprosthetic joint infection (PJI) following total knee arthroplasty (TKA). We aimed to validate the optimal cutoff values of ESR, CRP, and synovial fluid analysis for detecting early postoperative PJI in a large series of primary TKAs.

Methods: We retrospectively identified 27,066 primary TKAs performed between 2000 and 2019. Read More

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Nontuberculous mycobacterial infection of the knee after arthrocentesis for idiopathic hemarthrosis: A case report.

Ann Med Surg (Lond) 2021 May 16;65:102332. Epub 2021 Apr 16.

Departments of Orthopaedics and Rheumatology, Kindai University Nara Hospital, 1248-1 Otodacho, Ikoma, Nara, 630-0293, Japan.

Introduction: Nontuberculous mycobacterial (NTM) infections of the musculoskeletal system are uncommon. Such infections are typically acquired by direct inoculation after penetrating trauma, surgical procedures, or needle injections. There are no reported cases of NTM infection after arthrocentesis for idiopathic hemarthrosis of the knee. Read More

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Native joint septic arthritis due to in an adult.

IDCases 2021 31;24:e01106. Epub 2021 Mar 31.

Division of Infectious Diseases, Department of Internal Medicine, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA, 52242, USA.

A 65-year-old woman with chronic osteoarthritis of the knees presented with a one-week history of acutely worsening right knee pain and swelling. Arthrocentesis was performed and synovial fluid was indicative of septic arthritis with a negative Gram stain for bacteria. Magnetic Resonance Imaging (MRI) was obtained, revealing a large anterior periarticular abscess with concomitant septic arthritis. Read More

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