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Synovial Fluid Analysis

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

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General

Synonym/Acronym:
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.

Specimen:
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
ClarityClear
ViscosityHigh
ANAParallels serum level
C3Parallels serum level
GlucoseLess than 10 mg/dL of blood level
Lactic acid5–20 mg/dL
pH7.2–7.4
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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Citation

Bladh, Mickey Lynn., and Anne M. Van Leeuwen. "Synovial Fluid Analysis." Davis's Lab & Diagnostic Tests, 7th ed., F.A. Davis Company, 2017. Nursing Central, nursing.unboundmedicine.com/nursingcentral/view/Davis-Lab-and-Diagnostic-Tests/425329/all/Synovial_Fluid_Analysis.
Bladh ML, Van Leeuwen AM. Synovial Fluid Analysis. Davis's Lab & Diagnostic Tests. 7th ed. F.A. Davis Company; 2017. https://nursing.unboundmedicine.com/nursingcentral/view/Davis-Lab-and-Diagnostic-Tests/425329/all/Synovial_Fluid_Analysis. Accessed April 18, 2019.
Bladh, M. L., & Van Leeuwen, A. M. (2017). Synovial Fluid Analysis. In Davis's Lab & Diagnostic Tests. Available from https://nursing.unboundmedicine.com/nursingcentral/view/Davis-Lab-and-Diagnostic-Tests/425329/all/Synovial_Fluid_Analysis
Bladh ML, Van Leeuwen AM. Synovial Fluid Analysis [Internet]. In: Davis's Lab & Diagnostic Tests. F.A. Davis Company; 2017. [cited 2019 April 18]. Available from: https://nursing.unboundmedicine.com/nursingcentral/view/Davis-Lab-and-Diagnostic-Tests/425329/all/Synovial_Fluid_Analysis.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Synovial Fluid Analysis ID - 425329 A1 - Bladh,Mickey Lynn, AU - Van Leeuwen,Anne M, BT - Davis's Laboratory & Diagnostic Tests UR - https://nursing.unboundmedicine.com/nursingcentral/view/Davis-Lab-and-Diagnostic-Tests/425329/all/Synovial_Fluid_Analysis PB - F.A. Davis Company ET - 7 DB - Nursing Central DP - Unbound Medicine ER -