Influence of inflammatory arthritis on leukocyte esterase strip results in the diagnosis of periprosthetic joint infection

Abstract

Background: The leukocyte esterase (LE) strip is considered as a helpful method to detect infection, which might be influenced by other inflammatory diseases. This study aims to explore whether the centrifugation of synovial fluid could influence the positive result of LE strip caused by inflammatory arthritis during the diagnosis of periprosthetic joint infection (PJI). Methods: From March 2016 to December 2018, 64 patients who were diagnosed as PJI or aseptic arthritis and another 20 patients with inflammatory arthritis were enrolled in our study. After synovial fluid samples were obtained, the LE strip test was performed with and without centrifugation. Then clinicians read the color changes 3 min after the samples were dropped and classify the results based on the instruction of strip. The differences between septic and aseptic arthritis patients and septic and inflammatory arthritis patients were analyzed. Results: Among the included 21 PJI samples, 19 of them showed positive results (++) of LE strip before centrifugation. After centrifugation, two samples changed from two-positive (++) to one-positive (+), which is also considered as positive. Before centrifugation, 29 of the LE strip tests in the aseptic arthritis group (43 samples included) were ++ or +. After centrifugation, 16 of the samples yielded negative results. Among 20 samples with inflammatory arthritis, LE strip of 18 samples were positive (++ or +) before centrifugation, among which only 3 samples remained as positive after centrifugation. Conclusion: LE strip test results could be influenced by inflammatory arthritis during the diagnosis of PJI. Centrifugation should be performed for LE strip tests to determine whether the result is a true positive or a false positive influenced by inflammatory arthritis.

New insights into the interplay between autophagy and cartilage degeneration in osteoarthritis

“…Sex-determining region Y-box 4tbox4-activated lncRNA-MCM3AP antisense RNA 1 aggravated OA progression by modulating autophagy and ECM degradation via targeting miR-149-5p/Notch1 axis (Xu et al, 2022). Additionally, the circRNAs have also been involved in OA microenvironment for control of autophagy to perturb the situation of inflammation such as hsa_circ_0005567, ciRS-7, circPan3, has_circ_0037658, circMELK, and circRHOT1 (Zhang, Cheng, Rong, Tang, & Gui, 2020;Zhou et al, 2020;Sui, Liu, Que, Xu, & Hu, 2021; Frontiers in Cell and Developmental Biology frontiersin.org Zeng et al, 2021;Man et al, 2022;Zhang et al, 2022). Therefore, taking transcription factors, microRNA, lncRNA, circRNA, and autophagy inhibitors as entry points can serve as potential therapeutic targets for OA and represent a surprising new lead in the search for drugs to treat OA.…”