title: Clinical, radiological and molecular diagnosis correlation in serum samples from patients with osteoarticular tuberculosis.
abstract: OBJECTIVE
  To assess the role of polymerase chain reaction (PCR) in serum samples, in the diagnosis of osteoarticular tuberculosis (OTB) in a setting where only clinical and imaging diagnoses determine the treatment.
  
  
  METHODS
  A total of 44 consecutive serum specimens were collected from clinically suspected OTB patients, based on clinical and radiological [X-ray or magnetic resonance imaging/computed tomography] features. They were screened by in-house nested PCR. In addition, a few specimens were examined by Gram stain, acid-fast bacilli stain, histopathology and routine bacterial culture. A total of 39 specimens were collected from patients suffering from other bone diseases of nontuberculous origin and included as negative controls.
  
  
  RESULTS
  Of the 44 clinically suspected OTB patients, in-house nested PCR was positive in 40 (91%) cases; PCR was negative in 38 (97%) negative controls. Sensitivity and specificity of our in-house nested PCR was 90.9% and 97.4%, respectively. The PCR report was available within 48 h. It was possible to standardize serum PCR technique and in positive cases, a good correlation was observed in terms of an adequate treatment response.
  
  
  CONCLUSIONS
  Nested PCR in serum samples is a rapid, highly sensitive and specific modality for OTB detection. PCR should be performed in addition to clinical evaluation, imaging studies, acid-fast bacilli staining, culture and histopathology diagnosis, if possible.
authors.affiliation: Unidad de Investigación Médica en Inmunología e Infectología, Hospital de Infectología, Centro Médico Nacional La Raza (CMNR), Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico (Medical Research Unit in Immunology and Infectious Disease, Hospital for Infectious Disease, "La Raza"National Medical Center (CMNR), Mexican Social Security Institute (IMSS), Mexico City, Mexico).
authors.forename: Guadalupe
authors.initials: G
authors.lastname: García-Elorriaga
authors.affiliation: Hospital de Ortopedia "Dr. Victorio de la Fuente Narváez", Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico (Orthopedics Hospital "Dr. Victorio de la Fuente Narváez", Mexican Social Security Institute (IMSS), Mexico City, Mexico).
authors.forename: Olga
authors.initials: O
authors.lastname: Martínez-Elizondo
authors.affiliation: Banco Central de Sangre, CMNR, IMSS, and Departamento de Infectología, Hospital Infantil de México Federico Gómez. Secretaría de Salud (SSA), Mexico City, Mexico (Central Blood Bank, CMNR, IMSS and Department of Infectious Disease "Federico Gómez" Children's Hospital. Health Ministry (SSA), Mexico City, Mexico).
authors.forename: Guillermo
authors.initials: G
authors.lastname: Del Rey-Pineda
authors.affiliation: Unidad de Investigación Médica en Inmunología e Infectología, Hospital de Infectología, Centro Médico Nacional La Raza (CMNR), Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico (Medical Research Unit in Immunology and Infectious Disease, Hospital for Infectious Disease, "La Raza"National Medical Center (CMNR), Mexican Social Security Institute (IMSS), Mexico City, Mexico).
authors.forename: César
authors.initials: C
authors.lastname: González-Bonilla
keywords: Molecular diagnosis; Nested polymerase chain reaction; Osteoarticular tuberculosis; Sensitivity; Specificity