SYNOVIAL AND SEROUS FLUID Flashcards
AKA joint fluid
Synovial fluid
Viscosity is due to polymerization of
Hyaluronic acid
Produced by Type 3 synoviocytes
Hyaluronic acid
Type A synoviocytes promotes
Phagocytosis
Method of collection for synovial fluid
Arthrocentesis
Normal volume of synovial fluid
<3.5 mL.
Volume of synovial fluid in inflammation
> 25 mL
Tube for chemical and immunologic evaluation
Plain red top tube ( no anticoagulant)
Tube for chemical and immunologic evaluation
Plain red top tube ( no anticoagulant)
Anticoagulant for glucose analysis
Sodium fluoride
Powdered anticoagulants and lithium heparin may interfere with ____
Crystal identification
Tube for synovial fluid to be used for microscopic exam
Sodium heparin or liquid EDTA
Liquid EDTA for synovial fluid exam is used in what section
Hematology/ cell count
Normal color and clarity of synovial fluid
Colorless-pale yellow and clear
color and clarity of synovial fluid when there is an inflammation
Deeper yellow
color and clarity of synovial fluid in bacterial infection
Greenish tinge
color and clarity of synovial fluid in the presence of WBCs, synovial cell debris or fibrin
Turbid
color and clarity of synovial fluid with presence of crystals
Milky
Synovial fluid normal viscosity:
Highly viscous
Synovial fluid fluid forms string that is ______ cm long
4-6 cm
Normal Hyaluronic acid level
0.3 to 0.4 g/dL
Ropes of mucin clot test (Hyaluronic polymerization test) REAGENT
2-5% Acetic acid
GRADING: solid or compact clot; clear solution
Good
WBC count of synovial fluid: DILUTING FLUIDS
SALINE WITH SAPONIN
HYPOTONIC SALINE (0.3%)
NSS with METHYLENE BLUE
For every viscous fluid, add 1 drop of ___________ in phosphate buffer per mL of fluid
0.05% hyaluronidase
SYNOVIAL FLUID Differential count : RBC normal value
<2000/uL or ABSENT
SYNOVIAL FLUID Differential count : WBCs normal value
<200/uL
Neutrophil containing ingested “round body” seen in lupus erythymatosus
LE cell
Vacuolated macrophage with ingested neutrophil seen in REACTIVE ARTHRITIS
Reiter cell (neutrophage)
Neutrophil with dark cytoplasmic granules containing precipitated rheumatoid factor
RA cell (ragocyte)
Macroscopically resemble polished rice , it shows collagen and fibrin
Rice bodies
Debris from metal and plastic joint prosthetics
Ground pepper appearance
Orchonotic shards
Similar to macrophage but may be multinucleated resembling a mesothelial cell
Synovial cell lining
Refractile intracellular and extracellular globules stain with Sudan dyes
Fat droplets
Inclusions within clusters of synovial cells ; pigmented villonodular synovitis
Hemosiderin
CRYSTAL SHAPE: NEEDLES
MONOSODIUM URATES
CRYSTAL SHAPE: Rhombic, rods
Calcium pyrophosphate
CRYSTAL SHAPE: notched, rhombic plates
Cholesterol