The value of synovial fluid assays in the diagnosis of joint disease: a literature survey
The value of synovial fluid assays in the diagnosis of joint disease: a literature survey
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DOI：
10.1136/ard.61.6.493
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发表时间：
2002-06-01
影响因子：
27.4
通讯作者：
Dieppe, P
中科院分区：
文献类型：
--
作者：
Swan, A;Amer, H;Dieppe, P
目的：对文献进行评价性评价，评价目前滑液(SF)分析在关节疾病诊断中的价值。方法：应用Medline、BIMED、BIDS、Pubmed和Embase电子数据库检索文献，检索词：滑液(SF)分析、SF晶体、关节败血症、急性关节炎、SF细胞计数、细胞学、生物标志物和微生物学。首先，评估三种传统检测方法(微生物学、白细胞计数和致病晶体显微镜)的价值的报告。对于作者的从属关系，这些质量控制证据被发现是稀疏的，敏感性、特异性和可靠性的测试显示出令人担忧的变化。SF分析中的这些低标准可能是由于缺少与常规病理服务中的一些测试相对应的内容。其次，宣称“新的”分析方法(细胞学和生化标记物)是有用的。对于细胞学，支持证据主要是轶事，没有关于特异性、敏感性和可靠性的报告。解释困难是生化分析临床应用的主要障碍，生化分析仍然是主要的研究工具。最后，对SF分析的总体诊断价值进行了研究。这项评估证实，SF分析仍然对怀疑化脓性关节炎或晶状体关节病的急性关节炎以及痛风发作具有重要的诊断价值。结论：鉴于SF测试的重要性，合理使用SF测试，以及改进公认的质量控制，应该是当务之急。建议进一步研究SF检查和白细胞计数对诊断的贡献，以及SF微生物分析、晶体鉴定和细胞学的特异性和敏感性。
Objective: To carry out a critical appraisal of the literature in an attempt to assess the current value of synovial fluid (SF) analysis in the diagnosis of joint disease.Methods: A literature search was undertaken using the Medline, Biomed, Bids, Pubmed, and Embase electronic databases using the keywords: synovial fluid (SF) analysis, SF crystals, joint sepsis, acute arthritis, and SF cell counts, cytology, biomarkers, and microbiology.Results: Publications fell into three main categories. Firstly, reports assessing the value of the three traditional assays (microbiology, white blood cell counts, and microscopy for pathogenic crystals). For authors' affiliations these quality control evidence was found to be sparse, and tests for sensitivity, specificity, and reliability showed worrying variations. These poor standards in SF analysis may be due to lack of inclusion of Correspondence to: some tests within routine pathology services. Secondly, claims for the usefulness of "new" assays (cytology and biochemical markers). For cytology, the supporting evidence was mainly anecdotal and there were no reports on specificity, sensitivity, and reliability. Interpretation difficulties are a major hindrance to the clinical use of biochemical assays, which remain primarily research tools. Finally, work on the diagnostic value of SF analysis in general. The appraisal confirmed that SF analysis remains of major diagnostic value in acute arthritis, where septic arthritis or crystal arthropathy is suspected, and in intercritical gout,Conclusions: Given the importance of SF tests, rationalisation of their use, together with improved Accepted quality control, should be immediate priorities. Further investigation is recommended into the contribution of SF inspection and white cell counts to diagnosis, as well as of the specificity and sensitivity of SF microbiological assays, crystal identification, and cytology.