Likelihood of hip infection with image-guided hip aspiration dry tap: a 10-year retrospective study.
Dry tap; Hip infection; Image-guided hip aspiration; Total hip arthroplasty; MRI
Journal
Skeletal radiology
ISSN: 1432-2161
Titre abrégé: Skeletal Radiol
Pays: Germany
ID NLM: 7701953
Informations de publication
Date de publication:
Oct 2022
Oct 2022
Historique:
received:
13
12
2021
accepted:
27
03
2022
revised:
27
03
2022
pubmed:
2
4
2022
medline:
19
8
2022
entrez:
1
4
2022
Statut:
ppublish
Résumé
To determine the rate of infection in patients with suspected hip septic arthritis who underwent image-guided aspiration (IHA) resulting in dry-tap, diagnostic value of subsequent lavage and re-aspiration, and if pre-aspiration MRI can help prevent a dry tap. Retrospective review between 2010 to 2020 identified native hip (NH) and total hip arthroplasty (THA) patients who had a dry-tap following aspiration for suspected infection or periprosthetic joint infection (PJI). Serology tests, lavage/re-aspiration volumes, and aspirate cell-count/culture were assessed. On pre-aspiration MRI, presence/grade of joint effusion (JE), pseudocapsule dehiscence (PD), extraarticular fluid and sinus-tract were recorded. Out of 215 included dry-taps, 185 (86.0%) were non-infected and 30 (13.9%) infected. In subgroup analysis, 64/71(90.1%) NH and 121/144(84.0%) THA dry-taps were non-infected. Pre-aspiration MRI of THA group with dry-tap showed significant findings; PD with extraarticular fluid (8/12, 66.7%) and sinus tract (7/12, 58.3%) were higher in the infected compared to non-infected group (5/42, 11.9% and 0/42, 0.0%) (both p < 0.001). Among THA group, polymorphonuclear-leukocytes > 80% was present in 8/9 (88.9%) of infected versus 4/28 (14.3%) non-infected group (p < 0.001). Multivariable regression showed PD (p = 0.005) and JE (p = 0.042) being significant independent predictors of PJI, similarly the elevated CRP (p = 0.044) and JE (p = 0.017). Majority of patients suspected of hip joint infection with dry-tap were non-infected. Synovial PMN% following lavage maintains high sensitivity for detection of PJI. In patients with THA, PD and subsequent extraarticular collection can be associated with dry-tap therefore, pre-aspiration MRI can help determine their presence and plan the aspiration.
Identifiants
pubmed: 35359220
doi: 10.1007/s00256-022-04046-0
pii: 10.1007/s00256-022-04046-0
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1947-1958Informations de copyright
© 2022. The Author(s), under exclusive licence to International Skeletal Society (ISS).
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