Evidence map›Paper›PMID 41526897›Full record

ArticleBMC musculoskeletal disorders2026

Synovial-to-blood glucose ratio as a biomarker for the early diagnosis of septic arthritis of the knee in emergency medical practice: a retrospective clinical cohort study.

Hiroshi Okuno, Shinjiro Miura, Kiyotsugu Shinagawa, Tomonori Kunii, Daisuke Chiba, Hiroaki Ogawa, Shingo Nobuta, Toshimi Aizawa, Eiji Itoi

Abstract read
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Article in BMC musculoskeletal disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Hiroshi OkunoDepartment of Orthopaedic Surgery, Tohoku Rosai Hospital, Sendai, Japan. h-okuno@tohoku.ac.jp.
Shinjiro MiuraDepartment of Orthopaedic Surgery, Tohoku Rosai Hospital, Sendai, Japan.
Kiyotsugu ShinagawaDepartment of Orthopaedic Surgery, Tohoku Rosai Hospital, Sendai, Japan.
Tomonori KuniiDepartment of Orthopaedic Surgery, Tohoku Rosai Hospital, Sendai, Japan.
Daisuke ChibaDepartment of Orthopaedic Surgery, Tohoku Rosai Hospital, Sendai, Japan.
Hiroaki OgawaDepartment of Orthopaedic Surgery, Tohoku Rosai Hospital, Sendai, Japan.
Shingo NobutaDepartment of Orthopaedic Surgery, Tohoku Rosai Hospital, Sendai, Japan.
Toshimi AizawaDepartment of Orthopaedic Surgery, Tohoku University Hospital, Sendai, Japan.
Eiji ItoiDepartment of Orthopaedic Surgery, Tohoku Rosai Hospital, Sendai, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis study aimed to analyze both hematological and synovial biomarkers in patients with septic arthritis (SA) and patients with non-septic arthritis (non-SA) of the knee and identify useful biomarkers for the early diagnosis of SA in emergency medical practice.

methodsWe examined 397 knee joints of 367 patients with painful/swollen knee joints and potential infection at our department between May 2018 and May 2023. After excluding cases involving joints with prosthetic replacements, symptom duration more than 3 weeks, prior antibiotic use, and absence of arthrocentesis, 179 knee joints (166 patients) were assessed. To identify useful diagnostic parameters of the SA and non-SA groups, we compared their hematological and synovial fluid biomarkers and assessed the diagnostic performance of those biomarkers by conducting receiver-operating characteristic (ROC) analyses.

resultsHematological parameters, including the white blood cell (WBC) count, neutrophil sequestration, C-reactive protein level, and procalcitonin level, in the SA group were higher than those in the non-SA group. A synovial fluid examination revealed that the WBC count and neutrophil sequestration exhibited the same pattern. Synovial glucose levels and synovial-to-blood glucose ratios in the SA group were lower than those in the non-SA group. The ROC analysis revealed that the synovial-to-blood glucose ratio had the highest diagnostic utility for predicting SA.

conclusionsThe synovial-to-blood glucose ratio appears to be a promising biomarker; however, its ability to differentiate SA from non-SA warrants further validation. The synovial-to-blood glucose ratio may complement existing diagnostic tools and improve early diagnostic precision in emergency medical settings.

Indexed as

Arthritis, InfectiousBlood GlucoseGlucoseKnee JointSynovial FluidAdultAgedBiomarkersEarly DiagnosisEmergency Medical ServicesFemaleHumansLeukocyte CountMaleMiddle AgedRetrospective StudiesBiomarkersBlood GlucoseGlucoseDiagnosisEmergency departmentSeptic arthritisSynovial-to-blood glucose ratio

Identifiers

PMID41526897
PMCPMC12797685

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