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Joint Bone Spine
Volume 80, n° 6
pages 604-607 (décembre 2013)
Doi : 10.1016/j.jbspin.2013.04.001
accepted : 11 January 2013
Usefulness and limitations of rapid urine dipstick testing for joint-fluid analysis. Prospective single-center study of 98 specimens
 

Guillaume Coiffier , Stefan Pollet, Jean-David Albert, Aleth Perdriger, Pascal Guggenbuhl, Gérard Chales
 Service de Rhumatologie, Hôpital Sud, CHU de Rennes, 16, boulevard de Bulgarie, BP 90347, 35203 Rennes cedex 2, France 

Corresponding author.
Abstract
Objective

To evaluate the diagnostic performance of rapid urine reagent strip testing of joint fluid in separating mechanical from inflammatory disease.

Methods

In a prospective single-center 12-month study of joint fluid specimens, leukocyte esterase reagent strip testing (LERST) was compared to leukocyte counts used as the reference standard. Leukocyte counts greater than 2000/mm3 were taken to indicate inflammation. Reproducibility of LERST was evaluated by testing 73 specimens twice and computing Cohen's kappa coefficient.

Results

Ninety-eight joint fluid specimens (26 with mechanical and 72 with inflammatory characteristics) were evaluated. LERST had 79.2% sensitivity, 92.3% specificity, 96.6% positive predictive value, 61.5% negative predictive value, a positive likelihood ratio of 10.3, and a negative likelihood ratio of 0.23. The kappa coefficient was 0.70 (0.53–0.87). Two negative LERSTs a few minutes apart had 80% negative predictive value and a negative likelihood ratio of 0.08.

Conclusion

LERST of joint fluid is a rapid means of satisfactorily separating mechanical from inflammatory joint fluids.

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Keywords : Joint fluid, Urine dipstick, Reagent strip, Screening, Diagnosis, Inflammation




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