![]() ![]() In viral arthritis the synovial fluid white cell count is increased with predominantly mononuclear cells, although rubella has been associated with predominance of neutrophils. Not all cases of bacterial infection are associated with an elevated white cell count. These findings can also be present in other inflammatory joint conditions, eg, rheumatoid arthritis, rheumatic fever, and crystal arthropathy.Ĭell counts >100,000 x 10 6 /L suggest septic arthritis. In normal synovial fluid the cell count should be 50,000 x 10 6L (mainly neutrophils), low glucose (compared to concurrent plasma levels) and high protein. Normal synovial fluid is clear, straw-coloured, and being mucoid has a high viscosity, with a strong mucin clot after the addition of acetic acid. NAAT testing may be indicted for organisms such as Kingella species. Glucose, Protein, and Complement components C3 and C4, if appropriate. Microscopic examination: wet film including polarised light for the identification of crystals Gram stain and stains for Mycobacterium spp if appropriate. Synovial fluid cannot be fixed and should be transported to the laboratory immediately.Įven with refrigeration the specimen should reach the laboratory within 24 h. Optimally 5 mL synovial fluid in sterile container 5 mL in anticoagulant (lithium heparin or EDTA tube) if cell count required. Keywords: Joint Fluid, Crystals, Specimen:
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