ESR and CRP in Musculoskeletal infection

ESR (Erythrocyte Sedimentation Rate)

  1. Usually elevated within 48-72 hours of the infection onset (less reliable in the first 48 hours of infection)
  2. Continues to rise for 3-5 days after institution of successful therapy and continuing rise beyond 4th-5th day of treatment can be an indication of treatment failure (not good means of monitoring treatment during first week)
  3. Returns to normal over 2-4 weeks after elimination of infection.
  4. Elevated in 85%-95% cases of septic arthritis and in 90%-95% of osteomyelitis cases (significantly higher levels in septic arthritis than osteomyelitis)
ESR
MechESR / CC0

CRP (C-Reactive Protein)

  1. Begin to rise within 6 hours of the triggering stimulus (trauma or infection) and then increases several hundredfold
  2. Reaches a peak within 36-50 hours
  3. Falls to normal quickly with successful treatment because of short half-life (returns to normal within 1 week of successful treatment)
  4. Elevated in 98% of patients with osteomyelitis
  5. If CRP is <1.0 mg/dL, the probability that a patient does not have septic arthritis is 87%
  6. In the surgery group, it takes twice as long for the CRP and ESR to reach peak values and then twice as long to normalize after initiation of treatment.


Write your Viewpoint πŸ’¬

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.