Synovial Fluid Analysis
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Arthrocentesis, joint fluid analysis, knee fluid analysis.
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.
(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)
|Color||Colorless to pale yellow|
|ANA||Parallels serum level|
|C3||Parallels serum level|
|Glucose||Less than 10 mg/dL of blood level|
|Lactic acid||5–20 mg/dL|
|Protein||Less than 3 g/dL|
|RF||Parallels serum level|
|Uric acid||Parallels serum level|
|WBC count||Less than 200 cells/microL|
|Neutrophils||Less than 25%|
|WBC morphology||No abnormal cells or inclusions|
|Gram stain and culture||No organisms present|
|AFB smear and culture||No AFB present|
|AFB = acid-fast bacilli; ANA = antinuclear antibodies; C3 = complement; RBC = red blood cell; RF = rheumatoid factor; WBC = white blood cell.|