Introduction
Define/describe the condition
Anatomy
Describe the pertinent anatomy and provide links to relevant pages
Pathogeneis
Describe the biologic basis of the disorder or the mechanism of injury
Natural History
Describe the natural history,epidemiology and prognosis
Patient History and Physical Findings
Presence of fever: 57% sensitivity
Joint Pain: 85% sensitivity (95%CI 78-90)
Joint Swelling: 78% Sensitivity (95% CI 71-85)
Imaging and Diagnostic Studies
Gram Stain: Sensitivity only 29% – 50%
Culture: Sensitivity may only be 82%
Synovial Cell Count: The best diagnostic tool while awaiting culture results . Table data taken from Margaretten et al
Value | Likelihood Ratio | 95% CI |
|---|---|---|
WBC’s < 25,000 | 0.32 | 0.23-0.43 |
WBC’s > 25,000 | 2.9 | 2.5-3.4 |
WBC’s > 50,000 | 7.7 | 5.7-11.0 |
WBC’s > 100,000 | 28 | 12.0-66.0 |
PMN’s < 90% | 0.34 | 0.25-0.47 |
PMN’s >90% | 3.4 | 2.8-4.2 |
Peripheral White Blood Cell Count: Sensitivity: 90%; Specificity: 36%
ESR: Sensitivity: 95%; Specificity 29%
CRP: Sensitivity: 77%; Specificity: 53%
Differential Diagnosis
Treatment
Include:
Medical therapy
Nonoperative treatment
Operative treatment – include links to pages with detailed surgical techniques
Indications and contraindications
Pearls and Pitfalls
Tips and problems to avoid
Postoperative Care
Include immediate postoperative care and rehabilitation
Outcome
Include functional and prosthetic survivorship data as applicable
Complications
Include overview of complications
Selected References
http://www.ncbi.nlm.nih.gov/pubmed/17405973