Synovial Fluid Lactate for the Diagnosis of Joint Infection:A Systematic Review (original) (raw)

Many host-specific synovial fluid biomarkers were investigated for the diagnosis of joint infections; including lactate, adenosine deaminase, calprotectin, alfa-defensin, alpha-2-macroglobulin, C-reactive protein (CRP), leukocyte esterase, and interleukin-6 (IL-6). Therefore, we aimed to systematically review the current evidence discussing the usage of synovial fluid lactate as a biomarker in the diagnosis of joint infection. The search was conducted through seven databases with the usage of the search, followed by searching the references of included papers to avoid missing relevant included papers. We included papers reporting the use of D-lactate in synovial fluid for the diagnosis of joint infections. Finally, 13 papers, with 2243 recruited patients, were included in the study. In general, the synovial lactate showed a good diagnostic value with an area under the receiver operating characteristic curve (AUC) ranging from 76% [23] to 95% [8]. The sensitivity of diagnosing joint infection ranged from 73.3% [23] to 95.7% [8], while specificity ranged from 66.7% to 96%. In conclusion, the synovial fluid lactate can be used as a screening biomarker for septic arthritis, with having the advantages of being inexpensive, needs a small volume of synovial fluid, and short turnaround time. Several risk factors were reported to induce joint infection. Berbari., et al. indicated that rheumatoid arthritis, steroid therapy, malignancy in general, joint malignancy, diabetes mellitus, and previous arthroplasty are potential risk factors for joint infection [3]. Bacterial