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synovial fluid analysis

Reference values: 1) physical properties a) colorless b) transparent c) viscosity at 25 degrees: 5.7-1160 2) pH: 7.2-7.6 3) cell count a) WBC: < 200 /mm3 - neutrophils < 25% - lymphocytes 0-78% - monocytes 0-71% - macrophages 0-25% b) RBC: 0-2000/mm3 c) synovial cells 0-12% 4) protein a) total protein 1-3 g/dL (plasma 6-8 g/dL) b) albumin (55-60%) (plasma 50-65%) c) alpha-1 globulin (6-8%) (plasma 3-5%) d) alpha-2 globulin (5-7%) (plasma 7-13%) e) beta globulin (8-10%) (plasma 8-14%) f) gamma globulin (10-14%) (plasma 12-22%) - IgG 33-850 mg/dL - IgA 27-177 mg/dL - IgM -084 mg/dL g) fibrinogen: none 5) hyaluronate (0.3-0.4 g/dL) 6) glucose (70-110 mg/dL) (plasma 70-110 mg/dL) 7) uric acid (2-8 mg/dL) (plasma 2-8 mg/dL) Procedure: 1) routine a) gross examination (color & clarity) b) leukocyte count & differential c) Gram stain & bacterial culture (aerobic & anaerobic) d) crystal examination with polarizing microscope & compensator 2) other tests a) fungal & acid-fast stains & culture b) bacterial antigens c) serum-synovial glucose differential d) lactate e) complement f) enzymes Clinical significance: - see synovial fluid findings in disease states

Related

joint effusion (knee effusion) synovial fluid synovial fluid findings in disease states

Specific

cells in synovial fluid color of synovial fluid crystals in synovial fluid glucose in synovial fluid hyaluronate in synovial fluid IgA in synovial fluid IgG in synovial fluid IgM in synovial fluid mucin clot test (Ropes test) pH in synovial fluid protein in synovial fluid synovial fluid cell count turbidity of synovial fluid uric acid in synovial fluid viscosity of synovial fluid

General

clinical microbiology test

References

  1. Clinical Diagnosis & Management by Laboratory Methods, 19th edition, J.B. Henry (ed), W.B. Saunders Co., Philadelphia, PA. 1996, pg 467-472
  2. Laboratory Medicine: Test Selection & Interpretation. Howanitz & Howanitz (eds), Churchill Livingstone, NY, 1991, pg 116-121
  3. Medical Knowledge Self Assessment Program (MKSAP) 17, American College of Physicians, Philadelphia 2015
  4. Courtney P, Doherty M. Joint aspiration and injection and synovial fluid analysis. Best Pract Res Clin Rheumatol. 2013 Apr;27(2):137-69 PMID: 23731929
  5. Pascual E, Sivera F, Andres M. Synovial fluid analysis for crystals. Curr Opin Rheumatol. 2011 Mar;23(2):161-9. PMID: 21285711

Components

cells in synovial fluid