The diagnostic value of streptococcal serology in early arthritis: a prospective cohort study

Objective. To evaluate the diagnostic value of streptococcal serology in adult early arthritis patients in discriminating between post‐streptococcal reactive arthritis (PSRA) and arthritis with other causes. Methods. The antistreptolysin‐O (ASO) and anti‐DNase B tests were performed at baseline in 3...

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Published in:Rheumatology (Oxford, England) England), 2000-12, Vol.39 (12), p.1351-1356
Main Authors: Visser, H., Speyer, I., Özcan, B., Breedveld, F. C., van Ogtrop, M. L., Hazes, J. M. W.
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Antistreptolysin - analysis
Antistreptolysin‐O
Anti‐DNase B
Arthritis - diagnosis
Arthritis - microbiology
Arthritis, Infectious - diagnosis
Arthritis, Infectious - microbiology
Biological and medical sciences
Deoxyribonucleases - analysis
Deoxyribonucleases - immunology
Diagnosis
Diseases of the osteoarticular system
Early arthritis
Female
Humans
Inflammatory joint diseases
Male
Medical sciences
Middle Aged
Post‐streptococcal reactive arthritis
Predictive Value of Tests
Prospective Studies
Sensitivity and Specificity
Streptococcal serology
Streptococcus
Streptococcus - immunology
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Summary:Objective. To evaluate the diagnostic value of streptococcal serology in adult early arthritis patients in discriminating between post‐streptococcal reactive arthritis (PSRA) and arthritis with other causes. Methods. The antistreptolysin‐O (ASO) and anti‐DNase B tests were performed at baseline in 366 consecutive, newly referred early arthritis patients. After 1 yr of follow‐up the patients were classified according to international classification criteria and were evaluated for the presence of persistent arthritis. The outcome measures were the predictive value of streptococcal serology for the diagnosis of PSRA and the ability of this serology to discriminate at the first visit between the self‐limiting and persistent forms of arthritis. Results. With a positive serological result, the probability of having PSRA increased from 2 to 9%, whereas the probabilities of having rheumatoid arthritis or undifferentiated arthritis continued to be high (23 and 29% ). The serological tests did not discriminate between the self‐limiting and persistent forms of arthritis. The major Jones criteria apart from arthritis were not observed. Conclusion. Streptococcal serology has no diagnostic value in adult early arthritis patients in whom major Jones criteria other than arthritis are not present.
ISSN:1462-0324
1462-0332
DOI:10.1093/rheumatology/39.12.1351