Synovial Fluid

What makes synovial fluid viscous and slippery?

Hyaluronic Acid

Where is hyaluronic acid secreted from?

Synoviocytes

Synovial disorder caused by deterioration of the cartilage or joint structure

Non-inflammatory

Synovial disorder caused by an autoimmune response or infection

Inflammatory

Synovial disorder caused by microbial infection

Septic

Synovial disorder caused by trauma, tumors, or hemophilia

Hemorrhagic

What is the normal leukocyte count for synovial fluid?

<200 cells/µL

Needle aspiration of the synovial fluid is called:

Arthrocentesis

Deep yellow synovial fluid is caused by the presence of:

Excess proteins and/or cells

Green synovial fluid is caused by the presence of:

infection

Milky synovial fluid is caused by the presence of:

Crystals

Which disorder results from a deficiency in hyaluronic acid?

Osteoarthritis

What is used to assess the quality of hyaluronic acid in synovial fluid?

Ropes test (mucin clot test)

What could be considered a normal WBC count for a septic synovial fluid specimen?

>100,000 cells/µL

When should synovial fluid analysis be performed after collection?

ASAP

What percentage of WBCs in healthy synovial fluid would you expect to be neutrophils?

<25%

What percentage of WBCs in healthy synovial fluid would you expect to be lymphocytes?

<15%

Which condition can cause Monosodium urate (MSU) crystals to appear in synovial fluid?

Gout

Which condition can cause Calcium pyrophosphate dihydrate (CPPD) crystals to appear in synovial fluid?

Pseudogout

Which type of crystal are negative birefringent?

MSU

Which type of crystal are positive birefringent?

CPPD

Which type of synovial crystal is indicative of cartilage degeneration and can only be seen with an electron microscope?

Hydroxyapatite

Which type of synovial crystal is indicative of systemic autoimmune diseases?

Cholesterol

Which type of synovial crystal is found in renal dialysis patients?

Calcium oxalate

The synovial fluid value for glucose should be ____ lower than the blood value

<=10 mg/µL

What is used to preserve synovial fluid specimens when testing for glucose?

Sodium fluoride

Gout can cause an increase in:

Uric acid

Microbiology tests using synovial fluid use what?

Chocolate agar

Arthritis is a frequent complication of:

Lyme disease

The most common autoimmune causes of arthritis are:

Rheumatoid arthritis

Lupus Erythematosus

What is tested for to monitor Rheumatoid arthritis?

Enzymes

When should synovial specimens be tested for glucose after collection?

Within 1 hour