musculoskeletal and connective tissue disorders
Prosthetic Joint Infectious Arthritis
Diagnosis of Prosthetic Joint Infectious Arthritis
Clinical, microbiologic, pathologic, and imaging criteria The diagnosis of infection in a prosthetic joint often requires a combination of clinical, microbiologic, pathologic, and imaging criteria. Communication between a sinus tract and the prosthesis may also be considered diagnostic of infection. Synovial fluid should be sampled for cell count and culture. X-rays may show loosening of the prosthesis or periosteal reaction but are not diagnostic. Technetium-99m bone scanning and indium-labeled white blood cell scanning are more sensitive than plain x-rays but lack specificity in the immediate postoperative period. Ultimately, periprosthetic tissue collected at the time of surgery may be sent for culture and histologic analysis. 