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J Bone Jt Infect. 2019 Aug 2;4(4):167-173. doi: 10.7150/jbji.34854. eCollection 2019.

Factors to Consider When Assessing the Diagnostic Accuracy of Synovial Leukocyte Count in Periprosthetic Joint Infection.

Author information

1
Department of Orthopaedics, University of Groningen, University Medical Centre Groningen, the Netherlands.
2
Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, Switzerland.
3
Department of Laboratory Medicine, University of Groningen, University Medical Centre Groningen, The Netherlands.
4
Department of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University Basel, Basel, Switzerland.
5
Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland.
6
Institute for Infectious Diseases, University of Bern, Bern, Switzerland.
7
Department of Medical Microbiology and Infection Prevention, University of Groningen, University Medical Centre Groningen, The Netherlands.

Abstract

Synovial white blood cell (WBC) count and the percentage of polymorphonuclear leucocytes (PMN%) is one of the diagnostic criteria to diagnose a periprosthetic joint infection (PJI). Although the test is widely available, the diagnostic accuracy of proposed cut-off levels are influenced by several factors, such as: the affected joint, co-morbid conditions, the causative microorganism and the gathering and processing of samples in the laboratory. In this narrative review we provide an overview on how and to what extent these factors can affect the synovial WBC count and PMN% in synovial fluid.

KEYWORDS:

diagnosis; periprosthetic joint infection; polymorphonuclear percentage; synovial fluid; white blood cell count

Conflict of interest statement

Competing interests: The authors have declared that no competing interest exists.

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