Margaretten ME, Kohlwes J, Moore D, Bent S. JAMA. 2007 Apr 4;297(13):1478-88.
This 2007 systematic review found that (aside from specific clinical scenarios), history, physical exam and lab data were not particularly useful in confirming or ruling out the diagnosis of septic arthritis, and that suspected cases require synovial fluid analysis for better risk stratification. The group was disappointed the study was unable to guide avoidance of arthrocentesis, but found the study useful for informed discussions with consultants and for confirming the diagnostic difficulty of septic arthritis, even with synovial fluid analysis. By: Dr. Michael Ho (September 2014)
Epi lesson:QUADAS-2 Tool for Evaluation of Systematic Reviews of Diagnostic Accuracy Studies