Determining the Degree of Agreement between Computed Tomography Scan and Saline Test to Detect Knee Space Invading in Penetrating Trauma

Penetrating traumas to joints if not detected and properly treated, will be damaged, and causes intra-articular contamination and septic arthritis. At present, saline test is used to detect penetrating wound into the joint. Considering that it is invasive and painful, and is prone to infectious complications especially in busy emergency wards, the purpose of this study was to determine the consensus of computed tomography (CT) scan with saline test to increase the detection rate of penetrating knee trauma cases. This cross-sectional diagnostic study was done in the year 2017 in an emergency hospitals of the Iran University of Medical Sciences, Tehran, Iran. 62 patients with knee trauma were selected using convenience sampling method, and were evaluated using saline test and CT scan. Findings: Saline test was positive in 19 cases of 62 patients. Kappa agreement rate was 54.5% between the results of saline test with CT scan reported by radiologist and 43.9% with CT scan reported by emergency medicine specialist. According to the results of the study, there was no acceptable agreement between the results of saline test and CT scan, and CT scan could not be a good alternative to saline testing. However, concurrent testing and CT scan can be helpful; as there were negative results of saline test in cases of septic arthritis, which had positive CT scan results.