Figure 1. Preoperative and Intraoperative Diagnosis of PJI
• Sinus tract or persistent wound drainage
• Acute onset of prosthesis pain
• Chronic painful prosthesis
Orthopedic
referral
• History and physical exam
• Plain film of prosthesis
• Sedimentation rate and CRP
• Blood culturesa
Infection
suspected
Arthrocentesis
• Cell count
• Differential
• Aerobic and anaerobic culture
Infection suspected
or confirmed and
surgery planned
No infection
suspected
STOP
No infection
suspected
STOP
• Intraoperative inspectiona
• Histopathology
• 3 to six cultures OR ultrasonicate
of prosthesisa
a
See full text guidelines for details, definitions
3
