Objective: High mobility group Box1 (HMGB-1) is related to inflammation and many kinds of arthritic diseases. Septic arthritis is acute infectious arthritis with potentially devastating outcomes and needs to be diagnosed and treated in an emergent manner. It is not always easy to distinguish septic arthritis from other forms of acute arthritis. In this study, we aimed to find out if serum or synovial HMGB1 can be used for diagnosis and differentiation of septic arthritis.
Materials and Methods: Consecutive patients who were admitted to the emergency department with suspected knee septic arthritis were included in this study. Patients were divided into two groups as septic and non-septic arthritis regarding Newmans criteria. All patients underwent a laboratory analysis of serum and synovial fluid for white blood cell count, c-reactive protein, sedimentation, cultures, and HMGB1.
Results: There were 23 patients with acute bacterial septic arthritis and 21 with acute non-bacterial arthritis. No difference was observed regarding age and sex. In the septic group, serum WBC, body temperature, sedimentation, CRP and synovial WBC were significantly higher. However, no difference was observed between groups regarding serum and synovial HMGB1 levels.
Conclusion: Although HMGB1 may predict articular damage in any form of arthritis, serum or synovial HMGB1 of patients with bacterial septic arthritis are similar to patients with non-bacterial arthritis.