As both CRP and ESR have their limitations in PJI diagnosis and the Consensus document for the diagnosis of PJI [19] stated serum CRP and ESR should always be performed in patients with suspected PJI, but low CRP and ESR cannot rule out PJI, the meaning of various new serological markers has also been checked in PJI diagnosis [5–13]. This evidence concerns the gene ESR1 and juvenile polyposis syndrome.