Comparison of Serum Amyloid A Measurements in Equine Synovial Fluid With Routine Diagnostic Methods to Detect Synovial Infection in a Clinical Environment

<p dir="ltr">Synovial fluid analysis is utilized to diagnose septic synovitis. However, not all cases are clearly and rapidly discernible with the diagnostic tools available in the laboratory. Serum amyloid A (SAA), an acute phase protein, has been shown to be elevated in synovial fl...

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محفوظ في:
التفاصيل البيبلوغرافية
المؤلف الرئيسي: John David Stack (18131692) (author)
مؤلفون آخرون: Matthieu Cousty (18131695) (author), Emma Steele (18131698) (author), Ian Handel (330129) (author), Antoine Lechartier (7325921) (author), Tatiana Vinardell (530336) (author), Florent David (7932980) (author)
منشور في: 2019
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author John David Stack (18131692)
author2 Matthieu Cousty (18131695)
Emma Steele (18131698)
Ian Handel (330129)
Antoine Lechartier (7325921)
Tatiana Vinardell (530336)
Florent David (7932980)
author2_role author
author
author
author
author
author
author_facet John David Stack (18131692)
Matthieu Cousty (18131695)
Emma Steele (18131698)
Ian Handel (330129)
Antoine Lechartier (7325921)
Tatiana Vinardell (530336)
Florent David (7932980)
author_role author
dc.creator.none.fl_str_mv John David Stack (18131692)
Matthieu Cousty (18131695)
Emma Steele (18131698)
Ian Handel (330129)
Antoine Lechartier (7325921)
Tatiana Vinardell (530336)
Florent David (7932980)
dc.date.none.fl_str_mv 2019-10-01T00:00:00Z
dc.identifier.none.fl_str_mv 10.3389/fvets.2019.00325
dc.relation.none.fl_str_mv https://figshare.com/articles/journal_contribution/Comparison_of_Serum_Amyloid_A_Measurements_in_Equine_Synovial_Fluid_With_Routine_Diagnostic_Methods_to_Detect_Synovial_Infection_in_a_Clinical_Environment/25376431
dc.rights.none.fl_str_mv CC BY 4.0
info:eu-repo/semantics/openAccess
dc.subject.none.fl_str_mv Agricultural, veterinary and food sciences
Veterinary sciences
horse
septic
synovitis
serum amyloid A
specificity
sensitivity
infection
arthritis
dc.title.none.fl_str_mv Comparison of Serum Amyloid A Measurements in Equine Synovial Fluid With Routine Diagnostic Methods to Detect Synovial Infection in a Clinical Environment
dc.type.none.fl_str_mv Text
Journal contribution
info:eu-repo/semantics/publishedVersion
text
contribution to journal
description <p dir="ltr">Synovial fluid analysis is utilized to diagnose septic synovitis. However, not all cases are clearly and rapidly discernible with the diagnostic tools available in the laboratory. Serum amyloid A (SAA), an acute phase protein, has been shown to be elevated in synovial fluid from inflamed synovial structures. The goal of this study is to describe the correlation between two diagnostic tests measuring equine SAA levels in septic and non-septic synovial structures and to understand the correlation between an elevated SAA result and synovial sepsis. Prospective estimation of sensitivity (Se) and specificity (Sp) of two tests, handheld and ELISA, measuring SAA in synovial fluid was completed in 62 horses presented with injured synovial structures. The comparison was made to a reference diagnosis based on white cell count, percentage of neutrophils, intracellular bacteria and bacterial culture on synovial fluid. Handheld test levels were classified as: 4 lines visible—SAA level negative; 3 lines visible—SAA level mild; 2 lines visible—SAA level moderate; and 1 line visible—SAA level severe and compared to the numerical value obtained with ELISA test. The ELISA SAA test had an area under the curve of 0.88 (0.78–0.98). An ELISA cut-off of 23.95 μg/mL maximized Se and Sp. This cutoff gave a Se of 0.93 (0.66–1.00) and Sp of 0.77 (0.63–0.88). The handheld test was highly correlated with the ELISA SAA test (Spearman rank correlation 0.96) and at a cutoff of moderate or higher for positive results gave identical Se and Sp. Se and Sp of synovial fluid SAA are very reliable when clinical signs of synovitis are present for >6 h. This test, in conjunction with traditional methods, can assist practitioners to rapidly diagnose and expedite appropriate intervention of synovial sepsis.</p><h2>Other Information</h2><p dir="ltr">Published in: Frontiers in Veterinary Science<br>License: <a href="https://creativecommons.org/licenses/by/4.0/" target="_blank">https://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.3389/fvets.2019.00325" target="_blank">https://dx.doi.org/10.3389/fvets.2019.00325</a></p>
eu_rights_str_mv openAccess
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identifier_str_mv 10.3389/fvets.2019.00325
network_acronym_str Manara2
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oai_identifier_str oai:figshare.com:article/25376431
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spelling Comparison of Serum Amyloid A Measurements in Equine Synovial Fluid With Routine Diagnostic Methods to Detect Synovial Infection in a Clinical EnvironmentJohn David Stack (18131692)Matthieu Cousty (18131695)Emma Steele (18131698)Ian Handel (330129)Antoine Lechartier (7325921)Tatiana Vinardell (530336)Florent David (7932980)Agricultural, veterinary and food sciencesVeterinary scienceshorsesepticsynovitisserum amyloid Aspecificitysensitivityinfectionarthritis<p dir="ltr">Synovial fluid analysis is utilized to diagnose septic synovitis. However, not all cases are clearly and rapidly discernible with the diagnostic tools available in the laboratory. Serum amyloid A (SAA), an acute phase protein, has been shown to be elevated in synovial fluid from inflamed synovial structures. The goal of this study is to describe the correlation between two diagnostic tests measuring equine SAA levels in septic and non-septic synovial structures and to understand the correlation between an elevated SAA result and synovial sepsis. Prospective estimation of sensitivity (Se) and specificity (Sp) of two tests, handheld and ELISA, measuring SAA in synovial fluid was completed in 62 horses presented with injured synovial structures. The comparison was made to a reference diagnosis based on white cell count, percentage of neutrophils, intracellular bacteria and bacterial culture on synovial fluid. Handheld test levels were classified as: 4 lines visible—SAA level negative; 3 lines visible—SAA level mild; 2 lines visible—SAA level moderate; and 1 line visible—SAA level severe and compared to the numerical value obtained with ELISA test. The ELISA SAA test had an area under the curve of 0.88 (0.78–0.98). An ELISA cut-off of 23.95 μg/mL maximized Se and Sp. This cutoff gave a Se of 0.93 (0.66–1.00) and Sp of 0.77 (0.63–0.88). The handheld test was highly correlated with the ELISA SAA test (Spearman rank correlation 0.96) and at a cutoff of moderate or higher for positive results gave identical Se and Sp. Se and Sp of synovial fluid SAA are very reliable when clinical signs of synovitis are present for >6 h. This test, in conjunction with traditional methods, can assist practitioners to rapidly diagnose and expedite appropriate intervention of synovial sepsis.</p><h2>Other Information</h2><p dir="ltr">Published in: Frontiers in Veterinary Science<br>License: <a href="https://creativecommons.org/licenses/by/4.0/" target="_blank">https://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.3389/fvets.2019.00325" target="_blank">https://dx.doi.org/10.3389/fvets.2019.00325</a></p>2019-10-01T00:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.3389/fvets.2019.00325https://figshare.com/articles/journal_contribution/Comparison_of_Serum_Amyloid_A_Measurements_in_Equine_Synovial_Fluid_With_Routine_Diagnostic_Methods_to_Detect_Synovial_Infection_in_a_Clinical_Environment/25376431CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/253764312019-10-01T00:00:00Z
spellingShingle Comparison of Serum Amyloid A Measurements in Equine Synovial Fluid With Routine Diagnostic Methods to Detect Synovial Infection in a Clinical Environment
John David Stack (18131692)
Agricultural, veterinary and food sciences
Veterinary sciences
horse
septic
synovitis
serum amyloid A
specificity
sensitivity
infection
arthritis
status_str publishedVersion
title Comparison of Serum Amyloid A Measurements in Equine Synovial Fluid With Routine Diagnostic Methods to Detect Synovial Infection in a Clinical Environment
title_full Comparison of Serum Amyloid A Measurements in Equine Synovial Fluid With Routine Diagnostic Methods to Detect Synovial Infection in a Clinical Environment
title_fullStr Comparison of Serum Amyloid A Measurements in Equine Synovial Fluid With Routine Diagnostic Methods to Detect Synovial Infection in a Clinical Environment
title_full_unstemmed Comparison of Serum Amyloid A Measurements in Equine Synovial Fluid With Routine Diagnostic Methods to Detect Synovial Infection in a Clinical Environment
title_short Comparison of Serum Amyloid A Measurements in Equine Synovial Fluid With Routine Diagnostic Methods to Detect Synovial Infection in a Clinical Environment
title_sort Comparison of Serum Amyloid A Measurements in Equine Synovial Fluid With Routine Diagnostic Methods to Detect Synovial Infection in a Clinical Environment
topic Agricultural, veterinary and food sciences
Veterinary sciences
horse
septic
synovitis
serum amyloid A
specificity
sensitivity
infection
arthritis