Measurement error and correlation coefficients
Measurement error and correlation coefficients
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DOI：
10.1136/bmj.313.7048.41
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发表时间：
1996-07-06
影响因子：
--
通讯作者：
Altman, DG
中科院分区：
文献类型：
--
作者：
Bland, JM;Altman, DG
讨论 这些患者都是老年人，患有骨关节炎并同时患有其他部位的感染。然而，除了第二名患有骨髓增殖性疾病的患者外，没有人患有其他易导致感染的全身性疾病，例如糖尿病。血行扩散引起的化脓性关节炎与髋部疼痛加剧和股骨头快速破坏有关。这伴随着长达六个月的诊断延迟。众所周知，存在炎症性关节疾病，特别是类风湿性关节炎时的感染。尽管人们已经认识到这种情况，但与更常见的骨关节炎相关的情况却很少见。 2 与其他骨和关节感染一样，化脓性关节炎的表现近年来已与常见的严重疾病发生了变化。临床特征可能会减弱，特别是在老年人中，尤其是在使用抗生素治疗最初并发感染的过程中会减弱。如果漏诊或延误诊断，后果很严重：关节破坏可能会妨碍成功的关节置换术，或者更糟糕的是，髋关节置换术可能会被插入到无法识别的脓毒环境中。
Discussion These patients were all elderly and had pre-existing osteoarthritis and concurrent infection elsewhere. None, however, had other systemic conditions predis-posing to infection, such as diabetes, except for the second patient, who had a myeloproliferative disorder. The development of septic arthritis by haematogenous spread was associated with increasing hip pain and rapid destruction of the femoral head. This was accompanied by a delay in diagnosis of up to six months. Infection in the presence of existing inflammatory joint disease, particularly rheumatoid arthritis, is well known.'It is much rarer to see this in association with the much commoner osteoarthritis, although it is recognised. 2 In common with other bone and joint infections, the presentation of septic arthritis has changed in recent years from the usual florid illness.The clinical features may be muted, particularly in the elderly'and especially when attenuated by a course of antibiotics given to treat the original concurrent infection. If the diagnosis is missed or delayed, the consequences are serious: the joint destruction may preclude successful arthroplasty or, perhaps worse, a hip replacement may be inserted into an unrecognised septic environment.