{"id":"https://openalex.org/W7225419946","doi":"https://doi.org/10.1302/1358-992x.2026.11.081","title":"TAILORED DIAGNOSTICS IN JOINT ARTHRITIS: INSIGHTS FROM SYNOVIAL FLUID LEUKOCYTE COUNT, POLYMORPHONUCLEAR CELLS, PCR, AND CULTURE","display_name":"TAILORED DIAGNOSTICS IN JOINT ARTHRITIS: INSIGHTS FROM SYNOVIAL FLUID LEUKOCYTE COUNT, POLYMORPHONUCLEAR CELLS, PCR, AND CULTURE","publication_year":2026,"publication_date":"2026-11-06","ids":{"openalex":"https://openalex.org/W7225419946","doi":"https://doi.org/10.1302/1358-992x.2026.11.081"},"language":"en","primary_location":{"id":"doi:10.1302/1358-992x.2026.11.081","doi":"https://doi.org/10.1302/1358-992x.2026.11.081","is_oa":false,"landing_page_url":"https://doi.org/10.1302/1358-992x.2026.11.081","pdf_url":null,"source":{"id":"https://openalex.org/S4387287184","display_name":"Orthopaedic Proceedings","issn_l":"1358-992X","issn":["1358-992X","2049-4416"],"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Orthopaedic Proceedings","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5073781000","display_name":"Nele Geerts","orcid":"https://orcid.org/0000-0002-6807-4562","observed_orcids":["https://orcid.org/0000-0002-6807-4562"]},"institutions":[{"id":"https://openalex.org/I4210132212","display_name":"AZ Turnhout","ror":"https://ror.org/03fnbmw07","country_code":"BE","type":"other","lineage":["https://openalex.org/I4210132212"]}],"countries":["BE"],"is_corresponding":false,"raw_author_name":"Nele Geerts","raw_affiliation_strings":["AZ Turnhout - Department of Medical Microbiology, Turnhout, Belgium"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"AZ Turnhout - Department of Medical Microbiology, Turnhout, Belgium","institution_ids":["https://openalex.org/I4210132212"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5003562631","display_name":"Nathalie van Beek","orcid":"https://orcid.org/0009-0002-2806-4682","observed_orcids":["https://orcid.org/0009-0002-2806-4682"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Nathalie Van Beek","raw_affiliation_strings":["AZ St. Elisabeth Herentals - Department of Orthopaedics, Herentals, Belgium"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"AZ St. Elisabeth Herentals - Department of Orthopaedics, Herentals, Belgium","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5161084021","display_name":"Fien De Winter","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210132212","display_name":"AZ Turnhout","ror":"https://ror.org/03fnbmw07","country_code":"BE","type":"other","lineage":["https://openalex.org/I4210132212"]}],"countries":["BE"],"is_corresponding":false,"raw_author_name":"Fien De Winter","raw_affiliation_strings":["AZ Turnhout - Department of Medical Microbiology, Turnhout, Belgium"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"AZ Turnhout - Department of Medical Microbiology, Turnhout, Belgium","institution_ids":["https://openalex.org/I4210132212"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5044276037","display_name":"Johan Frans","orcid":"https://orcid.org/0000-0002-0440-8383","observed_orcids":["https://orcid.org/0000-0002-0440-8383"]},"institutions":[{"id":"https://openalex.org/I4210135614","display_name":"Imelda Hospital","ror":"https://ror.org/037s71n47","country_code":"BE","type":"healthcare","lineage":["https://openalex.org/I4210135614"]}],"countries":["BE"],"is_corresponding":false,"raw_author_name":"Johan Frans","raw_affiliation_strings":["Imelda ziekenhuis - Department of Medical Microbiology, Bonheiden, Belgium"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Imelda ziekenhuis - Department of Medical Microbiology, Bonheiden, Belgium","institution_ids":["https://openalex.org/I4210135614"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5017503167","display_name":"Truus Goegebuer","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4405284891","display_name":"AZ Sint-Maarten","ror":"https://ror.org/04crz8262","country_code":"BE","type":"healthcare","lineage":["https://openalex.org/I4405284891"]}],"countries":["BE"],"is_corresponding":false,"raw_author_name":"Truus Goegebuer","raw_affiliation_strings":["AZ Sint-Maarten - Department of Medical Microbiology, Mechelen, Belgium"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"AZ Sint-Maarten - Department of Medical Microbiology, Mechelen, Belgium","institution_ids":["https://openalex.org/I4405284891"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5065178131","display_name":"Wim Schuermans","orcid":"https://orcid.org/0000-0001-8613-2394","observed_orcids":["https://orcid.org/0000-0001-8613-2394"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Wim Schuermans","raw_affiliation_strings":["Ziekenhuis Geel - Department of Medical Microbiology, Geel, Belgium"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Ziekenhuis Geel - Department of Medical Microbiology, Geel, Belgium","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5039016658","display_name":"Ellen Van Even","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Ellen Van Even","raw_affiliation_strings":["Heilig Hart ziekenhuis - Department of Medical Microbiology, Lier, Belgium"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Heilig Hart ziekenhuis - Department of Medical Microbiology, Lier, Belgium","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5120082038","display_name":"Emma Claes","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Emma Claes","raw_affiliation_strings":["Heilig Hart ziekenhuis - Department of Medical Microbiology, Lier, Belgium"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Heilig Hart ziekenhuis - Department of Medical Microbiology, Lier, Belgium","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5116574181","display_name":"Peter Verbeeck","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Peter Verbeeck","raw_affiliation_strings":["H. Hartziekenhuis - Department of Medical Microbiology, Mol, Belgium"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"H. Hartziekenhuis - Department of Medical Microbiology, Mol, Belgium","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5068598519","display_name":"Danielle Van der Beek","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Danielle Van der Beek","raw_affiliation_strings":["AZ St. Elisabeth Herentals - Department of Medical Microbiology, Herentals, Belgium"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"AZ St. Elisabeth Herentals - Department of Medical Microbiology, Herentals, Belgium","institution_ids":[]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5075940105","display_name":"Heleen Nailis","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210132212","display_name":"AZ Turnhout","ror":"https://ror.org/03fnbmw07","country_code":"BE","type":"other","lineage":["https://openalex.org/I4210132212"]}],"countries":["BE"],"is_corresponding":false,"raw_author_name":"Heleen Nailis","raw_affiliation_strings":["AZ Turnhout - Department of Medical Microbiology, Turnhout, Belgium"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"AZ Turnhout - Department of Medical Microbiology, Turnhout, Belgium","institution_ids":["https://openalex.org/I4210132212"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":3,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.0,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"108-B","issue":"SUPP_11","first_page":"81","last_page":"81"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11293","display_name":"Orthopedic Infections and Treatments","score":0.9990000128746033,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11293","display_name":"Orthopedic Infections and Treatments","score":0.9990000128746033,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11381","display_name":"Infectious Diseases and Tuberculosis","score":0.0006000000284984708,"subfield":{"id":"https://openalex.org/subfields/2725","display_name":"Infectious Diseases"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11551","display_name":"Infective Endocarditis Diagnosis and Management","score":9.999999747378752e-05,"subfield":{"id":"https://openalex.org/subfields/2705","display_name":"Cardiology and Cardiovascular Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/native-joint-infection","display_name":"native joint infection","score":0.7229999899864197},{"id":"https://openalex.org/keywords/periprosthetic-joint-infection","display_name":"periprosthetic joint infection","score":0.9990000128746033},{"id":"https://openalex.org/keywords/synovial-fluid-pcr","display_name":"synovial fluid PCR","score":0.824999988079071},{"id":"https://openalex.org/keywords/synovial-fluid-culture","display_name":"synovial fluid culture","score":0.9039999842643738},{"id":"https://openalex.org/keywords/polymorphonuclear-leukocytes","display_name":"polymorphonuclear leukocytes","score":0.9269999861717224},{"id":"https://openalex.org/keywords/diagnostic-accuracy","display_name":"diagnostic accuracy","score":0.6579999923706055},{"id":"https://openalex.org/keywords/chronic-prosthetic-joint-infection","display_name":"chronic prosthetic joint infection","score":0.8040000200271606},{"id":"https://openalex.org/keywords/pathogen-detection","display_name":"pathogen detection","score":0.5839999914169312},{"id":"https://openalex.org/keywords/infection-prediction-model","display_name":"infection prediction model","score":0.367000013589859},{"id":"https://openalex.org/keywords/multiplex-pcr","display_name":"multiplex PCR","score":0.5249999761581421},{"id":"https://openalex.org/keywords/synovial-fluid-cytology","display_name":"synovial fluid cytology","score":0.5609999895095825}],"concepts":[{"id":"https://openalex.org/C2776268809","wikidata":"https://www.wikidata.org/wiki/Q25581","display_name":"Synovial fluid","level":4,"score":0.9345999956130981},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.7674000263214111},{"id":"https://openalex.org/C2777077863","wikidata":"https://www.wikidata.org/wiki/Q170990","display_name":"Arthritis","level":2,"score":0.45320001244544983},{"id":"https://openalex.org/C203014093","wikidata":"https://www.wikidata.org/wiki/Q101929","display_name":"Immunology","level":1,"score":0.4447999894618988},{"id":"https://openalex.org/C2776460866","wikidata":"https://www.wikidata.org/wiki/Q170065","display_name":"Pathogen","level":2,"score":0.44190001487731934},{"id":"https://openalex.org/C2777575956","wikidata":"https://www.wikidata.org/wiki/Q187255","display_name":"Rheumatoid arthritis","level":2,"score":0.43149998784065247},{"id":"https://openalex.org/C142724271","wikidata":"https://www.wikidata.org/wiki/Q7208","display_name":"Pathology","level":1,"score":0.4097000062465668},{"id":"https://openalex.org/C151956035","wikidata":"https://www.wikidata.org/wiki/Q1132755","display_name":"Logistic regression","level":2,"score":0.4068000018596649},{"id":"https://openalex.org/C3017807761","wikidata":"https://www.wikidata.org/wiki/Q708176","display_name":"Joint disease","level":4,"score":0.3677000105381012},{"id":"https://openalex.org/C189539697","wikidata":"https://www.wikidata.org/wiki/Q1125312","display_name":"Microbiological culture","level":3,"score":0.36559998989105225},{"id":"https://openalex.org/C3020326648","wikidata":"https://www.wikidata.org/wiki/Q924421","display_name":"Joint infections","level":4,"score":0.36039999127388},{"id":"https://openalex.org/C2781188995","wikidata":"https://www.wikidata.org/wiki/Q6934982","display_name":"Multiplex","level":2,"score":0.35929998755455017},{"id":"https://openalex.org/C90583042","wikidata":"https://www.wikidata.org/wiki/Q1952456","display_name":"Multiplex polymerase chain reaction","level":4,"score":0.3228999972343445},{"id":"https://openalex.org/C18555067","wikidata":"https://www.wikidata.org/wiki/Q8375051","display_name":"Joint (building)","level":2,"score":0.3167000114917755},{"id":"https://openalex.org/C3019719930","wikidata":"https://www.wikidata.org/wiki/Q3910099","display_name":"Predictive value","level":2,"score":0.29179999232292175},{"id":"https://openalex.org/C198433322","wikidata":"https://www.wikidata.org/wiki/Q3910099","display_name":"Predictive value of tests","level":2,"score":0.28439998626708984},{"id":"https://openalex.org/C2779663596","wikidata":"https://www.wikidata.org/wiki/Q2741512","display_name":"Synovial joint","level":5,"score":0.272599995136261},{"id":"https://openalex.org/C2779244835","wikidata":"https://www.wikidata.org/wiki/Q538432","display_name":"Synovitis","level":3,"score":0.2662999927997589},{"id":"https://openalex.org/C45189115","wikidata":"https://www.wikidata.org/wiki/Q502159","display_name":"Serology","level":3,"score":0.2635999917984009},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.2632000148296356}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.1302/1358-992x.2026.11.081","doi":"https://doi.org/10.1302/1358-992x.2026.11.081","is_oa":false,"landing_page_url":"https://doi.org/10.1302/1358-992x.2026.11.081","pdf_url":null,"source":{"id":"https://openalex.org/S4387287184","display_name":"Orthopaedic Proceedings","issn_l":"1358-992X","issn":["1358-992X","2049-4416"],"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Orthopaedic Proceedings","raw_type":"journal-article"}],"best_oa_location":null,"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","score":0.9940000176429749,"display_name":"Good health and well-being"}],"study_designs":[{"id":"https://openalex.org/study-designs/observational-study","display_name":"Observational Study"}],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W2120831553","https://openalex.org/W7165841840","https://openalex.org/W2765445139","https://openalex.org/W2796163787","https://openalex.org/W4309660608","https://openalex.org/W2549133358","https://openalex.org/W4415918152","https://openalex.org/W2588402213","https://openalex.org/W2594164410","https://openalex.org/W4408011551"],"abstract_inverted_index":{"Aim":[0],"Native":[1],"(JI)":[2],"and":[3,33,46,66,74,87,103,114,121,137,161,176,186,219,265,299,316,337,365],"prosthetic":[4,211,245],"joint":[5,56,194,205],"infections":[6],"(PJI)":[7],"pose":[8],"major":[9],"challenges":[10],"in":[11,51,191,202,233,271,358,381],"orthopaedics.":[12],"Timely":[13],"identification":[14],"of":[15,49,55,61,229,254,342,356],"the":[16,98,148,283,352],"causative":[17],"pathogen":[18,35],"is":[19,40],"critical":[20],"to":[21,83,146,257,329,371],"improve":[22],"patient":[23,234],"outcome.":[24],"Syndromic":[25],"multiplex":[26],"PCR":[27,223,255,266,281,312,343,376],"on":[28,92,153,171],"synovial":[29,62,94,129,154,172],"fluid":[30,95,130,155,173],"offers":[31],"rapid":[32],"accurate":[34],"detection.":[36],"A":[37],"multicenter":[38],"study":[39],"currently":[41],"being":[42],"conducted":[43],"evaluating":[44],"diagnostic":[45,261,269,354],"clinical":[47],"impact":[48],"PCR1":[50,81,357],"patients":[52,192,203,209,272,359],"with":[53,193,210,235,291,360],"symptoms":[54],"arthritis.":[57,206,362],"The":[58,163,252],"predictive":[59,164,295],"value":[60,165,370],"leukocyte":[63,85,133,335],"count":[64,86,175,185,293,318,336,364],"(WBC)":[65],"%":[67,88,135,158,177,187,320,338,366],"polymorphonuclear":[68],"cells":[69],"(PMN)":[70],"for":[71,106,117,150,166,208,226,274,286,334],"infection":[72,151,217,231,372],"diagnosis":[73,169,228,373],"microbial":[75,168],"positivity":[76],"was":[77,90,179,332],"also":[78,180,200],"investigated.":[79],"Methods":[80],"next":[82,256],"culture,":[84],"PMN":[89,105,116,136,178,188,213,300,321,339,367],"performed":[91],"114":[93],"samples":[96,131],"if":[97],"threshold":[99],"exceeded":[100],"50.000":[101],"WBC/\u00b5L":[102,113],"90%":[104],"JI":[107,287],"(Sanjo":[108],"criteria,":[109,125],"2023)":[110],"or":[111,319,344,377],"3.000":[112],"80%":[115],"PJI":[118,276],"(European":[119],"Bone":[120],"Joint":[122,391],"Infection":[123,392],"Society":[124],"2021).":[126],"In":[127,305],"50":[128],"only":[132],"count,":[134,157],"culture":[138,160,225,258,264,308,345,378],"were":[139,144,189,199,322],"analyzed.":[140],"Logistic":[141,278],"regression":[142,279],"models":[143],"constructed":[145],"estimate":[147],"probability":[149],"based":[152,170],"WBC":[156,174,184,197,292,317,363],"PMN,":[159],"PCR1.":[162],"positive":[167],"assessed.":[181],"Results":[182],"Mean":[183],"higher":[190],"infection,":[195],"but":[196],"thresholds":[198],"met":[201],"without":[204],"Only":[207],"joints,":[212],"better":[214],"distinguished":[215],"between":[216],"(>80%)":[218],"non-infectious":[220],"arthritis":[221],"(<80%).":[222],"outperformed":[224,311],"correct":[227],"acute":[230,361],"both":[232],"native":[236],"(PCR:":[237,247],"81%":[238],"vs.":[239,249],"culture:":[240,250],"72%)":[241],"as":[242,244,282,340],"well":[243],"joints":[246],"88%":[248],"80%).":[251],"use":[253],"further":[259],"increased":[260],"accuracy.":[262],"Both":[263],"showed":[267],"low":[268],"accuracy":[270,355],"suspected":[273],"chronic":[275,306,382],"(53%).":[277],"revealed":[280],"strongest":[284],"predictor":[285],"(p-value":[288,296,302,313,325],"<":[289,297],"0.05),":[290],"partially":[294],"0.05)":[298],"non-contributory":[301],"=":[303,314],"0.32).":[304],"PJI,":[307],"(p-value=":[309],"0.04)":[310],"0.37)":[315],"minimally":[323],"useful":[324],">":[326],"0.05).":[327],"Weak":[328],"no":[330],"correlation":[331],"observed":[333],"predictors":[341],"positivity.":[346],"Conclusions":[347],"Our":[348],"current":[349],"data":[350],"underscore":[351],"high":[353],"add":[368],"limited":[369],"nor":[374],"predict":[375],"positivity,":[379],"especially":[380],"PJI.":[383],"Acknowledgements":[384],"Supported":[385],"by":[386],"bioM\u00e9rieux,":[387],"France.":[388],"1":[389],"BIOFIRE\u00ae":[390],"Panel":[393],"(bioM\u00e9rieux,":[394],"France)":[395]},"counts_by_year":[],"updated_date":"2026-11-09T13:22:03.289127","created_date":"2026-11-07T00:00:00"}