title: [Staged diagnosis of septic hip endoprosthesis loosening with laboratory parameters and antigranulocyte scintigraphy].
abstract: OBJECTIVE
  The value of serial diagnosis of septic loosening of hip endoprosthesis using laboratory parameters and antigranulocytes scintigraphy was investigated and compared to joint aspiration.
  
  
  METHODS
  In 35 patients with intraoperative verification of infection, we calculated sensitivity, specify and prevalence dependent positive and negative predictive values for antigranulocyte scintigraphy, laboratory tests and the most suitable combination of both. We also calculated predictive values of joint aspiration using sensitivity and specify values given in the literature.
  
  
  RESULTS
  From negative and positive predictive values, of the sedimetation rate and leukocyte count provided no increase of information. We found the same result for positive predictive values of C-reactive protein. For antigranulocyte scintigraphy alone, we found a distinct but still unsatisfying increase of information. Nevertheless, in both cases infection could be excluded definitely. Therefore, the combination of C-reactive protein and antigranulocyte scintigraphy was suitable and the positive predictive values of this combination were only about 5% lower than those of joint aspiration. But with joint aspiration, infection could not be excluded.
  
  
  CONCLUSIONS
  A positive result in serial diagnosis using C-reactive protein and antigranulocyte scintigraphy leads to an distinct increase in the probability of infection which is comparable to that of joint aspiration. The additional advantages of this procedure are the certain exclusion of infection and the absence of invasiveness.
authors.affiliation: Klinik für Nuklearmedizin, Universitätsklinikum Giessen. Rigobert.Klett@radiol.med.uni-giessen.de
authors.forename: R
authors.initials: R
authors.lastname: Klett
authors.forename: A
authors.initials: A
authors.lastname: Khalisi
authors.forename: H
authors.initials: H
authors.lastname: Haas
authors.forename: M
authors.initials: M
authors.lastname: Puille
authors.forename: D
authors.initials: D
authors.lastname: Steiner
authors.forename: H
authors.initials: H
authors.lastname: Stürz
authors.forename: R
authors.initials: R
authors.lastname: Bauer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000378:metabolism*; D005260:Female; D006098:Granulocytes; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis* / Q000601:surgery; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000175:diagnosis* / Q000601:surgery; D016719:Radioimmunodetection; D012680:Sensitivity and Specificity; D013667:Technetium
chemical_list: D013667:Technetium; D002097:C-Reactive Protein
vernacular_title: Stufendiagnostik septischer Hüftendoprothesenlockerungen mittels Laborparametern und Antigranulazytenszintigraphie.