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Previous Volume 361:787-794 August 20, 2009 Number 8 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the authors' clinical recommendations.

A 62-year-old woman with osteoarthritis presents with a 7-month history of progressively worsening left hip pain radiating to the groin, 8 months after undergoing total left-hip arthroplasty. The pain has not responded to nonsteroidal antiinflammatory drugs. Physical examination reveals a sinus tract overlying her left hip. Her leukocyte count is 8000 per cubic millimeter, and the C-reactive protein (CRP) level is 15.5 . . . [Full Text of this Article]

The Clinical Problem

Strategies and Evidence

Diagnostic Approach

            C-Reactive Protein

            Imaging

            Synovial-Fluid Studies

            Histopathological Examination of Periprosthetic Tissue

            Intraoperative Microbiologic Testing

Treatment

Prophylaxis

Areas of Uncertainty

Guidelines

Conclusions and Recommendations

Source Information

From the Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology (R.P.), and the Division of Infectious Diseases, Department of Medicine (J.L.D.P., R.P.), Mayo Clinic College of Medicine, Rochester, MN.

An audio version of this article is available at NEJM.org.

Address reprint requests to Dr. Patel at the Division of Clinical Microbiology and the Division of Infectious Diseases, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, or at patel.robin@mayo.edu.

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