Comparison of Serum Amyloid A Measurements in Equine Synovial Fluid With Routine Diagnostic Methods to Detect Synovial Infection in a Clinical Environment.
Abstract: 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.
Copyright © 2019 Stack, Cousty, Steele, Handel, Lechartier, Vinardell and David.
Publication Date: 2019-10-01 PubMed ID: 31632987PubMed Central: PMC6779708DOI: 10.3389/fvets.2019.00325Google Scholar: Lookup
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- Journal Article
- Clinical Findings
- Clinical Pathology
- Clinical Study
- Comparative Study
- Correlation Analysis
- Diagnosis
- Diagnostic Technique
- Disease Diagnosis
- Disease Treatment
- Equine Health
- Horses
- In Vivo
- Infection
- Inflammation
- Laboratory Methods
- Sepsis
- Serum Amyloid A
- Synovial Fluid
- Veterinary Care
- Veterinary Medicine
- Veterinary Practice
Summary
This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.
This study explores the potential of using Serum Amyloid A (SAA) measurements to diagnose septic synovitis in horses, comparing it with routine diagnostic methods. The study found that using SAA could help in the quick diagnosis and treatment of synovial sepsis, particularly when traditional materials do not provide clear results.
Objective and Research Methodology
- The study aims to understand the correlation between septic and non-septic synovial structures in horses using two types of diagnostic tests that measure SAA levels.
- These two tests, the handheld and ELISA tests, were applied on 62 horses with injured synovial structures.
- The collected data was then compared to reference data that was based on white cell count, neutrophils percentage, presence of intracellular bacteria, and bacterial culture in synovial fluid.
Diagnostic Tests
- For the handheld test, levels were classified into four categories based on the visibility of lines, which indicate SAA levels. These categories are negative, mild, moderate, and severe.
- The results of the handheld test were then compared to the numerical results obtained from the ELISA test.
Findings and Conclusions
- The ELISA test yielded an area under the curve of 0.88, indicating a high level of accuracy in the test.
- At an optimal cut-off of 23.95 μg/mL, the ELISA test delivers a sensitivity i.e., true positive rate of 0.93 and a specificity i.e., true negative rate of 0.77.
- The handheld test showed a high correlation with the ELISA test (0.96), and positive results above the moderate level yielded identical specificity and sensitivity rates.
- These results suggest that SAA measurements in synovial fluid are reliable for diagnosing synovitis with over 6 hours of clinical signs.
- Notably, using this alongside traditional methods can assist clinical practitioners to diagnose synovial sepsis promptly and advance appropriate interventions swiftly.
Cite This Article
APA
Stack JD, Cousty M, Steele E, Handel I, Lechartier A, Vinardell T, David F.
(2019).
Comparison of Serum Amyloid A Measurements in Equine Synovial Fluid With Routine Diagnostic Methods to Detect Synovial Infection in a Clinical Environment.
Front Vet Sci, 6, 325.
https://doi.org/10.3389/fvets.2019.00325 Publication
Researcher Affiliations
- Institute of Veterinary Science, University of Liverpool, Neston, United Kingdom.
- Centre Hospitalier Vétérinaire Equin de Livet, Saint-Michel-de-Livet, France.
- Clinique Vétérinaire de la Côte Fleurie, Bonneville-sur-Touques, France.
- The Royal (Dick) School of Veterinary Studies, The Roslin Institute, The University of Edinburgh, Midlothian, United Kingdom.
- Clinique Vétérinaire Equine de Meheudin, Écouché, France.
- Equine Veterinary Medical Center, Member of Qatar Foundation, Doha, Qatar.
- College of Health and Life Sciences, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar.
- Equine Veterinary Medical Center, Member of Qatar Foundation, Doha, Qatar.
- College of Health and Life Sciences, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar.
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Citations
This article has been cited 9 times.- Jacobsen S, Mortensen CD, Høj EA, Vinther AM, Berg LC, Adler DMT, Verwilghen D, van Galen G. Neutrophil Gelatinase-Associated Lipocalin in Synovial Fluid from Horses with and without Septic Arthritis. Animals (Basel) 2022 Dec 21;13(1).
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