Does the presence of both an erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) below the periprosthetic joint infection (PJI) thresholds rule out the diagnosis of a PJI?

Does the presence of both an erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) below the periprosthetic joint infection (PJI) thresholds rule out the diagnosis of a PJI?

Authors: Montri D. Wongworawat, Jay Shah, Grigor Grigoryan, Jonathan D. Creech

RECOMMENDATION: Serum ESR and CRP levels below the threshold (as determined by the MusculoSkeletal Infection Society (MSIS) and International Consensus Meeting (ICM)) does not exclude the diagnosis of a PJI. Serum levels of ESR and CRP can be normal in some cases of PJI caused by slow-growing organisms.

LEVEL OF EVIDENCE: Moderate

DELEGATE VOTE: Agree: 100%, Disagree: 0%, Abstain: 0% (Unanimous, Strongest Consensus)

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