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

Review

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

Karsten D Ottink1✉, Carol Strahm2, Anneke Muller-Kobold3, Parham Sendi4,5,6, Marjan Wouthuyzen-Bakker7

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

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How to cite this article:
Ottink KD, Strahm C, Muller-Kobold A, Sendi P, Wouthuyzen-Bakker M. Factors to Consider When Assessing the Diagnostic Accuracy of Synovial Leukocyte Count in Periprosthetic Joint Infection. J Bone Jt Infect 2019; 4(4):167-173. doi:10.7150/jbji.34854. Available from http://www.jbji.net/v04p0167.htm