Frontiers in Cellular and Infection Microbiology (Apr 2023)

Detection of inguinal lymph nodes is promising for the diagnosis of periprosthetic joint infection

  • Leilei Qin,
  • Leilei Qin,
  • Chen Zhao,
  • Chen Zhao,
  • Hai Wang,
  • Hai Wang,
  • Jianye Yang,
  • Jianye Yang,
  • Li Chen,
  • Li Chen,
  • Xudong Su,
  • Xudong Su,
  • Li Wei,
  • Li Wei,
  • Tao Zhang,
  • Tao Zhang,
  • Jia Li,
  • Changchun Jian,
  • Changchun Jian,
  • Ning Hu,
  • Ning Hu,
  • Wei Huang,
  • Wei Huang

DOI
https://doi.org/10.3389/fcimb.2023.1129072
Journal volume & issue
Vol. 13

Abstract

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BackgroundLocalized inguinal lymphadenopathy often represents lower extremity pathogen infection, while normalized lymphadenopathy is associated with infection regression. We hypothesized that inguinal lymph nodes (LNs) were enlarged in Periprosthetic Joint Infection (PJI) patients and that normalized inguinal LNs would be a promising way to determine the timing of reimplantation.MethodsWe prospectively enrolled 176 patients undergoing primary and revision hip or knee arthroplasty. All patients underwent ultrasound examination of inguinal LNs preoperatively. The diagnostic value of inguinal LNs in PJI was evaluated by the receiver operating characteristic (ROC) curve.ResultsThe median level of inguinal LNs was 26mm in the revision for PJI group compared with 12 mm in the aseptic revision group (p< 0.0001). The size of the inguinal LNs well distinguishes PJI from aseptic failure (AUC= 0.978) compare with ESR (AUC= 0.707) and CRP (AUC= 0.760). A size of 19mm was determined as the optimal threshold value of the inguinal LNs for the diagnosis of PJI, with a sensitivity of 92% and specificity of 96%.ConclusionUltrasonic analysis of inguinal LNs is a valuable piece of evidence for the diagnosis of PJI and evaluation of persistent infection.

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