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Septic and crystal-induced arthritis (related to calcium pyrophosphate deposition disease or gout) are the two main causes of acute knee arthritis. The features of septic and crystal-induced arthritis are very similar, with a high level of acute pain, sharp inflammatory syndrome and occasionally fever, so the differential diagnosis is difficult.1 2
Pyogenic septic arthritis of the knees is associated with high mortality and morbidity and is considered a medical emergency.3 In case of severe sepsis, probabilistic antibiotic therapy and close monitoring are recommended.4 Gram staining and culture of synovial fluid (SF) are the gold standard for the diagnosis of septic arthritis, but identifying the bacterium often takes several days. Examining SF for the identification of crystals allows for a definite diagnosis of gout and CPP crystal arthritis but requires skills and facilities that are not always present in the primary care setting or in emergency departments. …
Handling editor Josef S Smolen
Contributors AV collected the data. PR and AV designed the study and wrote the manuscript. AO performed the statistical analysis. A-CC, TB, AL and H-KE improved the final draft
Funding This study was funded by "ART Viggo".
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Provenance and peer review Not commissioned; externally peer reviewed.
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