synovial fluid analysis

Reference interval

• physical properties
  • colorless
  • transparent
  • viscosity at 25 degrees: 5.7-1160
• pH: 7.2-7.6
• cell count
  • WBC: < 200 /mm3
    • neutrophils < 25%
      • lymphocytes 0-78%
      • monocytes 0-71%
      • macrophages 0-25%
  • RBC: 0-2000/mm3
  • synovial cells 0-12%
• protein
  • total protein 1-3 g/dL (plasma 6-8 g/dL)
  • albumin (55-60%) (plasma 50-65%)
  • alpha-1 globulin (6-8%) (plasma 3-5%)
  • alpha-2 globulin (5-7%) (plasma 7-13%)
  • beta globulin (8-10%) (plasma 8-14%)
  • gamma globulin (10-14%) (plasma 12-22%)
    • IgG 33-850 mg/dL
    • IgA 27-177 mg/dL
    • IgM -084 mg/dL
  • fibrinogen: none
• hyaluronate (0.3-0.4 g/dL)
• glucose (70-110 mg/dL) (plasma 70-110 mg/dL)
• uric acid (2-8 mg/dL) (plasma 2-8 mg/dL)

Clinical significance

• see synovial fluid findings in disease states

Procedure

• routine
  • gross examination (color & clarity)
  • leukocyte count & differential
  • Gram stain & bacterial culture (aerobic & anaerobic)
  • crystal examination with polarizing microscope & compensator
• other tests
  • fungal & acid-fast stains & culture
  • bacterial antigens
  • serum-synovial glucose differential
  • lactate
  • complement
  • enzymes

More general terms

• clinical microbiology test

More specific terms

• cells in synovial fluid
• color of synovial fluid
• crystals in synovial fluid
• glucose in synovial fluid
• hyaluronate in synovial fluid
• IgA in synovial fluid
• IgG in synovial fluid
• IgM in synovial fluid
• mucin clot test (Ropes test)
• pH in synovial fluid
• protein in synovial fluid
• synovial fluid cell count
• turbidity of synovial fluid
• uric acid in synovial fluid
• viscosity of synovial fluid

Additional terms

• joint effusion (knee effusion)
• synovial fluid
• synovial fluid findings in disease states

Components

• cells in synovial fluid