An observational study in Arthritis, sponsored by Rennes University Hospital. Completed at 1 site in France. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2021-03-03.
Sponsored by Rennes University Hospital · Observational
Observational study
Septic arthritis is a diagnostic emergency for acute arthritis because it is accompanied by an excess of mortality of 11% and frequent functional sequelae in about 50% of cases in the year. However, it remains rare with an estimated annual incidence of 1 to 5/100000, and a prevalence of about 10% in front of an acute arthritis table sent to an emergency department.
The diagnosis is based on the bacteriological culture which finds the presence of a microorganism within the joint. However, only 80% of septic arthritis is bacteriologically documented due to low inoculum, the presence of fragile bacteria (Neisseria sp) or especially untimely antibiotherapy prior to joint puncture.
In addition, the bacteriological culture takes an average of 3 days to become positive, which may delay the implementation of appropriate antibiotic therapy.
It is therefore essential that the clinician can rely on other clinical or biological parameters, reliable and fast for better diagnostic orientation.
A first study: SYNOLACTATES showed the interest of the measurement of glucose and synovial lactate for the diagnosis of septic arthritis with very good performances. A RESAS score (REnnes Septic Arthritis Score) was constructed from these results to assess the likelihood of septic arthritis.
123 studies on the registry are indexed under Arthritis, Infectious; 25 are open to participants now.
This study's enrollment of 244 is above the median of 100 across 72 observational studies indexed under Arthritis, Infectious.
Browse Arthritis, Infectious studies →Rennes University Hospital is the lead sponsor of 440 studies on the registry; 51 are open to participants now.
Counted across the registry records on this site, refreshed daily.
Patients performing joint puncture in routine care as part of a diagnostic assessment of acute arthritis
Exclusion Criteria:
RESAS (Rennes Septic Arthritis Score)
Composite score of 4 biological variables of the synovial liquid (macroscopically purulent liquid and/or Synovial White Cells Counts (SWCC) ≥ 75000/mm3, synovial crystal vizualization, synovial lactate dosage, synovial glucose dosage). Each variable is weighted as follows: macroscopically purulent liquid or SWCC ≥ 75000/mm3 (+3 points), UMS (-4 points) or CPP (-2 points) crystal Vizualization, lactate ≥ 11.5 mmol/L (+6 points) or 10-11.4 mmol/L (+4 points) or 8.5-9.9 mmol/L (+2 points), glucose ≤ 1.0 mmol/L (+4 points), 1.1-1.8 mmol/L (+2 points), yielding a total between -4 and 13.
Time frame: Up to 3 days (time to collect laboratory results)
Macroscopic synovial fluid appearance
Expressed in multiple qualitative variable: purulent, trouble, clear citrine appearance, hemarthrosis or clear with blood threads
Time frame: Up to 1 day (time to collect clinical parameters)
Microscopic synovial analysis
Presence of crystals in synovial fluid: urate monosodic (UMS) crystal (Yes or No), and calcium pyrophosphate crystal (CPP) (Yes or No)
Time frame: Up to 3 days (time to collect laboratory results)
Synovial White Cells Count (SWCC)
Number (n) of White cells in synovial fluid. (quantitative variable expressed in n/mm3)
Time frame: Up to 3 days (time to collect laboratory results)
Total lactates, D-lactate, glucose
Measures of total lactate, D-lactate et glucose in synovial fluid (quantitative variable expressed in mmol/L)
Time frame: Up to 3 days (time to collect laboratory results)
Others synovial proteic markers
Measures of CRP (mg/L) in synovial fluid
Time frame: Up to 3 days (time to collect laboratory results)
Others synovial proteic markers
Measures of Procalcitonine (ng/mL) in synovial fluid
Time frame: Up to 3 days (time to collect laboratory results)
Others synovial proteic markers
Measures of Calprotectin (ng/mL) in synovial fluid
Time frame: Up to 3 days (time to collect laboratory results)
Multielemental analysis by ICP-MS
Screening multielemental in synovial fluid
Time frame: Up to 3 days (time to collect laboratory results)
Number of classical clinical marker (quantitative variable) to diagnosis of septic arthritis
Fever (expressed in Celcius degree)
Time frame: Up to 1 day (time to collect clinical parameters)
Number of classical clinical marker (quantitative variable) to diagnosis of septic arthritis
Duration of symptoms (expressed in day)
Time frame: Up to 1 day (time to collect clinical parameters)
Number of classical clinical marker (qualitative variable) to diagnosis of septic arthritis
Co-morbidity promoting infection (diabetes, cirrhosis, HIV, severe chronic renal failure, rheumatoid arthritis, other inflammatory rheumatic diseases, immunosuppressive treatments such as corticosteroids, conventional synthetic-DMARDs, biological-DMARDs) (Yes or No)
Time frame: Up to 1 day (time to collect clinical parameters)
Number of classical clinical marker (qualitative variable) to diagnosis of septic arthritis
Number of joints affected (Ordinal variable)
Time frame: Up to 1 day (time to collect clinical parameters)
Parameters that may influence the bacteriological results of synovial fluid
NSAIDs, corticosteroids, antibiotics within 15 days of joint puncture (qualitative variable: Yes or No)
Time frame: Up to 1 day (time to collect clinical parameters)
Number of hospitalization potentially avoided by the early elimination of an arthritis diagnosis and their cost, from the point of view of illness insurance
Time frame: Date of hospitalization until 2 months of follow-up
This study is completed, as verified in Mar 2021. You cannot join it, but the record below documents what was studied.
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Rennes University Hospital