Saline Load or CT for Traumatic Arthrotomy

August 4, 2020

Traditionally, the saline load test (SLT) has been used to assess traumatic arthrotomy associated with periarticular wounds to help determine if patients need to go to the operating room for irrigation and debridement to prevent septic arthritis. However, CT can also be used for this purpose. What do you know about the use of these tests in this setting? Test your knowledge with the following quiz.

Review “Saline Load or CT: What’s the Best Test for Traumatic Arthrotomy?” in ACEP Now before you answer the question.

Which of the following is NOT a factor to consider when deciding to use SLT versus CT to evaluate joint capsule status in traumatic arthrotomy?

SLT can produce false negative results if not enough saline is loaded into the joint when evaluating joint capsule integrity. Other factors, such as joint position during the test, might also influence test accuracy.

In a 2013 study of 62 patients with periarticular knee wounds, CT scan had 100 percent sensitivity and specificity for diagnosing traumatic knee arthrotomy via the presence of intra-articular air; sensitivity of SLT was 92 percent.

Although SLT may be better than clinical judgment alone, only relatively weak evidence supports its use in evaluating traumatic arthrotomy.

At most institutions, CT is generally accepted as the standard of care when evaluating a patient for a traumatic knee arthrotomy.