Posted on 02/12/2023 9:26:42 PM PST by ConservativeMind
Measurement of plasma D-dimer levels—a test more commonly used to detect blood-clotting disorders—can provide useful information when making the difficult diagnosis of periprosthetic joint infection (PJI), reports a study.
Plasma D-dimer measurement has "comparable diagnostic accuracy" to other commonly used tests for identifying PJI, and in some situations outperforms standard tests, according to research by Javad Parvizi, MD, FRCS.
PJI is a devastating complication of failed total hip or knee replacement and is one of the leading causes of implant failure.
Two common markers of inflammation—C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR)—are recommended as screening tests for suspected PJI. However, both have limitations, including a high rate of false-negative results when PJI is present.
Plasma D-dimer is a commonly used test for certain blood clot-related disorders.
After application of the 2018 International Consensus Meeting definition of PJI, 23% of patients were found to have PJI. The four tests had "comparable accuracy" for the diagnosis of PJI. Sensitivity (ability to detect PJI when present) was 81.3% for D-dimer, 90.4% for CRP, 73.9% for ESR, and 74.7% for fibrinogen. On the other hand, specificity (correctly showing that PJI was not present) was 81.7% for D-dimer, 70.0% for CRP, 85.2% for ESR, and 75.4% for fibrinogen. For all four measures, values were higher for patients who were shown to have PJI.
However, in certain patient subgroups, D-dimer offered a diagnostic advantage. In a subanalysis that excluded patients with certain health conditions associated with inflammation, the D-dimer test outperformed ESR, fibrinogen, and CRP in recognizing the presence of PJI. D-dimer also performed best in detecting PJI caused by slow-growing "indolent" organisms, with higher values for both sensitivity and specificity. In addition, all four tests had better diagnostic performance in patients with suspected PJI in the knee, as compared with PJI in the hip.
(Excerpt) Read more at medicalxpress.com ...
“Another common test has been identified that can help identify early problems. “
I’ll bet it can be used in other early injec... uhh “problems”
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