Deanehan et al reported a clinical prediction rule for evaluating a pediatric patient with monoarthritis of the knee. The rule can exclude septic arthritis and help to direct the evaluation. The authors are from Boston Children's Hospital, Melbourne Medical School, Yale University, and Connecticut Children's Medical Center.
Patient selection: pediatric patient with knee monoarthritis
Parameters:
(1) absolute neutrophil count in 10^9/L
(2) erythrocyte sedimentation rate (ESR) in mm in first hour
Features identifying septic arthritis of the knee:
(1) absolute neutrophil count >= 10 * 10^9/L
(2) ESR >= 40 mm in first hour
Performance:
• The sensitivity is 100% but specificity of 54%.
• If both features are absent, then septic arthritis is ruled out.
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