Septic arthritis is difficult to diagnose because clinical presentations overlap with non infectious causes and laboratory, imaging, synovial and blood tests are insensitive. Although relatively uncommon, septic arthritis can be severely destructive to joints so the impetus is to give treatment without delay, often prior to a definitive diagnosis. This means patients can undergo invasive procedures, hospital admissions and antibiotics unnecessarily. This brings attendant risks in expanding antibiotic resistance and expense. This study aims to identify biomarkers in blood, urine and synovial fluid that are unique to patients with septic arthritis in order to aid in the rapid and accurate stratification of the acute joint presentation.
Primary objective: To identify blood, urine and synovial fluid biomarkers that are unique to patients with septic arthritis.
Secondary Objective: To determine, through whole genome sequencing of bacterial isolates, whether they are unique to septic arthritis and if there are any molecular signatures associated with a poor structural and systemic prognosis.
Sample: Adults presenting to the Emergency department with likely septic arthritis in one joint or more.
Trail design: Cross sectional proof of concept study
Strokes caused by a clot are described as ischaemic. When patients experience ischaemic strokes they may be eligible for “clot busting” therapy (thrombolysis). Currently thrombolysis has been shown to improve patient outcome after a stroke if administered within the first 4.5 hours after stroke onset. Up to 25% of patients wake up with symptoms of a stroke. This means they have an unknown onset time for their stroke (so called ‘wake up strokes’). With no known onset time, they are ineligible for thrombolysis. This study will investigate how we might determine stroke onset time.
The Emergency Medicine Annotated Bioresource Consortium (EM-ABC): A pilot and feasability programme
Developing a bioresource for all emergency presentations