Evaluation of Serum Procalcitonin Levels in Patients of Acute Osteomyelitis and Septic Arthritis

Abstract

Aims: The aim is to study the role of serum procalcitonin (PCT) levels in early diagnosis of acute osteomyelitis (OM) and septic arthritis (SA). Settings and Design: This is a prospective study in a tertiary hospital. Subjects and Methods: This study was done at a tertiary care hospital. Thirty-nine patients with SA or acute OM who attended the outpatient department or emergency were included in the study. 39 patients were taken as control group out of which one patient lost to follow-up, so 38 patients were left with control group. PCT level was evaluated by using immunoluminetric assay and a cutoff value of 0.5 ng/ml was taken as positive. After collection of data, sensitivity, specificity, positive predictive value, and negative predictive value are calculated for PCT. Statistical Analysis Used: Mann–Whitney U-test and Kruskal–Wallis test were used. Results: The sensitivity for PCT was 94.87 (95% confidence interval [CI] 82.68–99.37), specificity was 86.84 (95% CI 71.91–95.59), positive predictive value was 88.10%, and negative predictive value was 94.29%, when taking cutoff of 0.5 ng/ml. We have taken 0.5 ng/ml as a cutoff point for PCT; however, as per receiver operator characteristic of this study, the cutoff point was 1.1 ng/ml. Conclusions: This study clearly showed that PCT can be helpful in the early diagnosis of OM and SA, along with other indicators such as total leukocyte count, erythrocyte sedimentation rate, and C-reactive protein.

Keywords

• osteomyelitis; procalcitonin; septic arthritis