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首页> 外文期刊>Journal of Korean medical science >Application of a Novel Diagnostic Rule in the Differential Diagnosis between Acute Gouty Arthritis and Septic Arthritis
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Application of a Novel Diagnostic Rule in the Differential Diagnosis between Acute Gouty Arthritis and Septic Arthritis

机译：一种新的诊断规则在急性痛风性关节炎和败血性关节炎的鉴别诊断中的应用

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摘要

Septic arthritis and gout are major diseases that should be suspected in patients with acute monoarthritis. These two diseases are clinically similar and often indistinguishable without the help of synovial fluid analysis. Recently, a novel diagnostic rule for gout without synovial fluid analysis was developed and showed relevant performances. This study aimed to determine whether this diagnostic rule could perform well in distinguishing gout from septic arthritis. The diagnostic rule comprises 7 clinical and laboratory variables, each of which is given a specified score. The probability of gout is classified into 3 groups according to the sum of the scores: high (>= 8), intermediate (> 4 to < 8) and low probability (<= 4). In this retrospective study, we applied this diagnostic rule to 136 patients who presented as acute monoarthritis and were subsequently diagnosed as acute gout (n = 82) and septic arthritis (n = 54) based on synovial fluid analysis. The mean sum of scores of acute gout patients was significantly higher than that of those with septic arthritis (8.6 +/- 0.2 vs. 3.6 +/- 0.32, P < 0.001). Patients with acute gout had significantly more 'high', and less 'low' probabilities compared to those with septic arthritis (Eta[eta]: 0.776). The prevalence of acute gouty arthritis, as confirmed by the presence of monosodium crystal, was 95.5% (61/64), 57.5% (19/33), and 5.1% (2/39) in high, intermediate and low probability group, respectively. The recently introduced diagnostic rule properly discriminates acute gout from septic arthritis. It may help physicians diagnose gout in cases difficult to be differentiated from septic arthritis.
机译：化脓性关节炎和痛风是急性单关节炎患者应怀疑的主要疾病。这两种疾病在临床上是相似的，并且在没有滑液分析的情况下通常无法区分。最近，开发了一种无需滑液分析的新型痛风诊断规则，并显示出相关的性能。这项研究旨在确定该诊断规则在区分痛风和脓毒性关节炎方面是否能很好地发挥作用。诊断规则包括7个临床和实验室变量，每个变量均具有指定的分数。痛风的概率根据得分的总和分为3组：高（> = 8），中级（> 4至<8）和低概率（<= 4）。在这项回顾性研究中，我们将这一诊断规则应用于136例急性单关节炎患者，随后根据滑液分析将其诊断为急性痛风（n = 82）和化脓性关节炎（n = 54）。急性痛风患者的平均总分显着高于感染性关节炎的患者（8.6 +/- 0.2 vs. 3.6 +/- 0.32，P <0.001）。与感染性关节炎的患者相比，患有急性痛风的患者的“高”概率和“低”的概率明显更高（Etaη：0.776）。高，中，低概率组中存在单钠晶体证实的急性痛风性关节炎的患病率分别为95.5％（61/64），57.5％（19/33）和5.1％（2/39），分别。最近引入的诊断规则正确地将急性痛风与败血性关节炎区分开。如果难以与败血性关节炎相鉴别，它可以帮助医生诊断痛风。

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