SABER study (Septic Arthritis Biomarker Emergency Rule-out study)
Research type
Research Study
Full title
Developing a molecular tool to stratify the acute joint presentation: facilitating early diagnosis of septic arthritis
IRAS ID
219339
Contact name
Iain B McInnes
Contact email
Sponsor organisation
NHS Greater Glasgow & Clyde
Duration of Study in the UK
3 years, 0 months, 1 days
Research summary
Acute joint swelling, a limping child or a child unwilling to weight-bear/move a joint due to pain are common presentations to the Emergency Department. Excluding trauma, the most likely cause is either joint infection, known as ‘septic arthritis’, or non-infectious ‘inflammatory’ causes such as gout and transient synovitis (referred to as ‘irritable hip’ when the hip joint is involved). Previous work has demonstrated that bacteria and their toxins are highly destructive to joint tissues such as bone and cartilage and therefore a delay in diagnosis and initiation of treatment, which typically involves a combination of intravenous antibiotics coupled with joint irrigation, may have severe clinical consequences.
Septic arthritis is considered by the assessing clinician on the basis of patient history, clinical examination findings and abnormal blood tests but is only confirmed through the identification of bacteria within blood cultures or fluid aspirated from the joint in question, a process that may take 24-48hrs. Frequently however, no bacteria are identified in patients in whom clinical features and blood tests would suggest infection. The aim of this study therefore is to identify unique septic arthritis ‘biomarkers’ (naturally occurring molecules, genes, or characteristics by which a particular disease process can be identified) through the analysis of synovial fluid (joint fluid), blood and urine samples of adult patients presenting with acute joint swelling and children presenting with either an atraumatic limp or reluctance to move a joint due to pain, with the ultimate goal of developing novel bedside tests to delineate rapidly between infectious and inflammatory joint swelling, thereby facilitating the early diagnosis of septic arthritis. Patients recruited to this study will not undergo invasive procedures solely for the purpose of the study and all blood and urine samples will be collected as ‘additional volumes’ during routine investigations considered necessary by the assessing clinicians.
REC name
West of Scotland REC 5
REC reference
17/WS/0060
Date of REC Opinion
20 Apr 2017
REC opinion
Further Information Favourable Opinion