Davis's Lab & Diagnostic Tests

Synovial Fluid Analysis

Synovial Fluid Analysis is a topic covered in the Davis's Lab & Diagnostic Tests.

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Arthrocentesis, joint fluid analysis, knee fluid analysis.

Common Use:
To identify the presence and assist in the management of joint disease related to disorders such as arthritis and gout.

Synovial fluid collected in a red-top tube for antinuclear antibodies (ANAs), complement, crystal examination, protein, rheumatoid factor (RF), and uric acid; sterile (red-top) tube for microbiological testing; lavender-top (EDTA) tube for mucin clot/viscosity, complete blood count (CBC) and differential; gray-top (sodium fluoride [NaFl]) tube for glucose; green-top (heparin) tube for lactic acid and pH.

Normal Findings:
(Method: Macroscopic evaluation of appearance; spectrophotometry for glucose, lactic acid, protein, and uric acid; Gram stain, acid-fast stain, and culture for microbiology; microscopic examination of fluid for cell count and evaluation of crystals; ion-selective electrode for pH; nephelometry for RF and C3 complement; indirect fluorescence for ANAs)

TestNormal Result
ColorColorless to pale yellow
ANAParallels serum level
C3Parallels serum level
GlucoseLess than 10 mg/dL of blood level
Lactic acid5–20 mg/dL
ProteinLess than 3 g/dL
RFParallels serum level
Uric acidParallels serum level
CrystalsNone present
RBC countNone
WBC countLess than 200 cells/microL
NeutrophilsLess than 25%
WBC morphologyNo abnormal cells or inclusions
Gram stain and cultureNo organisms present
AFB smear and cultureNo AFB present
AFB = acid-fast bacilli; ANA = antinuclear antibodies; C3 = complement; RBC = red blood cell; RF = rheumatoid factor; WBC = white blood cell.

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