Study of Alpha-Defensin and Other Synovial Proteins to Improve Diagnosis of Joint Infection in Children

What this Trial Is About

Differentiating septic arthritis from other causes of joint inflammation in children is critical because septic arthritis requires prompt surgical treatment to prevent lasting joint damage. This study aims to evaluate the accuracy of several synovial fluid biomarkers, including alpha-defensin and others, in diagnosing pediatric septic arthritis. The research focuses on improving rapid diagnosis since current culture methods take several days, causing delays in treatment decisions. Participants include children under 18 years old undergoing joint fluid sampling due to suspected infection or inflammation, as well as normative controls undergoing unrelated procedures without infection. Various synovial fluid tests will be performed, such as alpha-defensin assay, leukocyte esterase test, neutrophil elastase, synovial C-reactive protein, and culture tests. Blood tests and PCR for Kingella kingae in children under 8 will also be conducted. These tests will be compared to joint fluid culture, the current gold standard. Participants take part in one study visit during which joint aspiration or arthroscopy is performed as part of their usual care. Researchers will analyze the synovial fluid and blood samples for these biomarkers and compare results to culture outcomes. The primary outcome is the sensitivity and specificity of these experimental tests for diagnosing infection. Data from this single visit will help determine if these tests can improve early detection of pediatric septic arthritis.

Alpha-Defensin and Synovial Proteins to Improve Detection of Pediatric Septic Arthritis