The Role of Serum Procalcitonin in Establishing Diagnosis of Bone and Joint Infections

Journal of Clinical Orthopaedics | Vol 5 | Issue 1 |  Jan-Jun 2020   | page: 3-7 | John Nolan, Putu Feryawan Meregawa

Author: John Nolan [1], Putu Feryawan Meregawa [2]

[1] Faculty of Medicine, Udayana University, Denpasar.
[2] Departement of Orthopaedic and Traumatology, Medical Faculty, Udayana University-Sanglah General Hospital Denpasar, Indonesia.

Address of Correspondence
John Nolan,
Faculty of Medicine, Udayana University, Denpasar


Background: Acute bone and joint infection such as septic arthritis and osteomyelitis diagnostic are still considered as a pitfall especially in the emergency department. Some laboratory markers, such as total Count (TC), Erythrocyte Sedimentation Rate (ESR) and C – Reactive Protein (CRP) assessed regularly whereas those are not specific. Serum PCT has a role as a sensitive and specific marker in supporting the diagnosis of bone and joint infections.
Method: Literature review is done by searching journals with “serum procalcitonin”, “bone infections”, “diagnosis”, and “joint infections” on the search engines. From 37 journals that were reviewed, 34 were found suitable as reference for this paper.
Outcome: High level of serum PCT indicate the activation of immune system, specifically the innate immune system due to microbial infections. One of the most different aspect with CRP is serum PCT infrequently elevates in response to viral infection, which means PCT is useful in differentiating bacterial and viral infections Serum PCT concentration elevates following the endotoxin or cytokines release such as interleukin (IL)- 6, tumor necrosis factor (TNF)-alpha, and IL-1b which usually appears in bone and joint infections. Although its benefits, there are some limitation interfering the usage and levels of serum PCT.
Conclusion: Serum PCT has a role as a sensitive and specific marker in supporting the diagnosis of bone and joint infections due to its sensitivity following endotoxins release. Further researches and studies are required to identify the appropriate usage, interfering factors, and clinical application of serum PCT in establishing the diagnosis of bone and joint infections.
Keywords: Procalcitonin, Bone infections, joint infections, Diagnosis.


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How to Cite this article: Nolan J, Meregawa P.F. The Role of Serum Procalcitonin in Establishing Diagnosis of Bone and Joint Infections. Journal of Clinical Orthopaedics Jan-Jun 2020;5(1): 3-7.

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