Clinical Findings of Lentino in a Patient with a Prosthetic Joint Infection

 

Clinical findings in a patient with prosthetic joint infection may include:

(1) pain in the joint (most frequent symptom)

(2) exacerbation of the pain with joint motion

(3) local warmth

(4) local tenderness

(5) drainage

(6) joint effusion

(7) fever, which may be low grade or intermittent

 

The presence of both a normal erythrocyte sedimentation rate (ESR) and normal C-reactive protein (CRP) is a good indicator for a very low risk of infection (Hanssen).

 

The presence of pathogenic bacteria in joint drainage or aspirated effusion indicates infection but may be negative in the presence of periprosthetic osteomyelitis, especially if the patient is receiving antibiotics.

 

Imaging studies may be helpful in evaluating the patient, especially nuclear medicine scans. A technetium bone scan is very sensitive but with limited specificity; this may be helpful to exclude infection. FDG-PET scans show a 90% sensitivity and 72-89% specificity (72% knee, 89% hip).