PHILADELPHIA — Results presented at the Musculoskeletal Infection Society Annual Open Scientific Meeting showed patients with periprosthetic joint infection had a low correlation coefficient for erythrocyte sedimentation rate and C-reactive protein.
“When you are evaluating patients for PJI, I think it is important to not disregard CRP just because the ESR is not elevated,” Joshua Bingham, MD, said in his presentation here. “I think the study emphasizes that while the [Musculoskeletal Infection Society] MSIS criteria is helpful, it is not perfect and there is still a significant role for clinical judgement to make that diagnosis.”
Bingham and colleagues matched 90 patients with PJI to 92 patients without PJI based on age, gender and BMI. Investigators determined Pearson correlation coefficient for an elevated ESR and CRP in both groups.
Univariate analysis showed significant differences in American Society of Anesthesiologists score and Charlson Comorbidity Index between the two groups.
“As previously we published in the literature, the synovial cell count was by far the most predictive test of the minor criteria and both CRP and ESR were the least predictive of infection,” Bingham said.
He noted patients in the PJI group had poor correlation between ESR and CRP compared with patients in the non-PJI group who had a high correlation coefficient.
“The other thing we saw was that there was a significant number of patients that had both negative ESR and CRP that were still diagnosed with an infection,” Bingham said. – by Casey Tingle
Bingham J, et al. ESR and CRP have a high discordant rate in PJI. Presented at: Musculoskeletal Infection Society Annual Open Scientific Meeting; July 27-28, 2018; Philadelphia.
Disclosure: Bingham reports no relevant financial disclosures.