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Case Reports
. 2017 Jul 23;3(4):239-241.
doi: 10.1016/j.artd.2017.05.006. eCollection 2017 Dec.

False-negative synovial alpha-defensin

Jake R Adams  1 , Adam J Schwartz  1
Affiliations
Case Reports

False-negative synovial alpha-defensin

Jake R Adams et al. Arthroplast Today. .

Abstract

We present a case of chronic periprosthetic hip infection diagnosed using the Musculoskeletal Infection Society criteria as the gold standard. The alpha-defensin test was falsely negative. The diagnostic workup of the patient is detailed, along with a discussion regarding the potential reasons behind the misleading alpha-defensin results. To our knowledge, this is the first reported case of a false-negative alpha-defensin test in the setting of an open sinus tract communicating with a culture-positive total hip implant. The alpha-defensin test should be interpreted cautiously, along with all relevant pertinent clinical data. In certain cases, similar to those described here, the Musculoskeletal Infection Society criteria may perform better than this particular biomarker.

Keywords: Alpha defensin; Biomarker; Periprosthetic joint infection; Total hip arthroplasty.

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Figures

Figure 1
Figure 1
(a) Clinical photograph of the patient's right hip wound and draining sinus. (b) Magnetic resonance imaging demonstrating the sinus communicating with the prosthetic joint.
Figure 2
Figure 2
Preoperative anteroposterior (AP) radiograph of the right hip showing a well-fixed cementless total hip arthroplasty.
Figure 3
Figure 3
Postoperative AP hip radiograph after placement of antibiotic spacer.
Figure 4
Figure 4
Postoperative AP hip radiograph after reimplantation.
See this image and copyright information in PMC

References

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