Synovial fluid analysis Flashcards
What is the normal amount of fluid in a small vs. large joint?
small <0.5 mL
Large <1 mL
Pale yellow joint fluid in a horse is abnormal. T/F?
FALSE (normal)
What does yellow, yellow/orange, and red jt fluid indicate?
yellow= cells, crystals
yellow-orange= RBC breakdown
red= hemorrhage
What could make cloudy joint fluid?
cells
fibrin
crystals
Why would the viscosity be decreased in joint fluid?
WBC/bacteria breakdown mucin d/t proteases
Dilution
decrease production from synovium damage
Would you expect this joint to have normal jt fluid viscosity?
No, decrease eosinophilic background (= less mucin)
What is the normal protein concentration in joint fluid?
< 2.5 g/dL
What is the normal nucleated cell counts in jt fluid?
<3,000 (dogs, but rest of species lower)
What cell type should dominate in jt fluid?
mononuclear cells (>90%) (phagocytes, lymphs)
NT (<10)
Normal or abnormal cell in joint fluid?
synovial lining cells (clasmatocyte)
normal in joint fluid
What is the predominant cell type in inflammatory vs. non-inflammatory abnormal joint fluid?
inflammatory: NT
non-inflammatory: mononuclear cells (but too many or extremely reactive)
Differentials for non-inflammatory abnormal jt fluid?
DJD
trauma
hemoarthrosis
neoplasia
Differentials for an Inflammatory neutrophilic joint fluid?
infectious
immunologic
nonimmunologic
What is the most common cause of a non-inflammatory joint fluid? What diagnostic would likely be performed after the joint tap?
DJD
radiographs
With hemarthrosis, NT can be common but not greater than 50%. T/F?
TRUE
Inflammatory or not?
Type?
What do the vacuoles in the macrophages indicate?
Non-inflammatory (mononuclear dominant)
hemoarthrosis
inflammation
Which type of dogs will get neoplasia in the joints?
middle age, large breed, large joint
Top three neoplasia primary in joint?
histiocytic sarcoma
synovial cell sarcoma
synovial myxoma
Inflammatory or not?
Type?
What is the pink material?
Non-inflammatory
neoplastic
osteoid
What unique characteristic is seen with inflammatory joint fluid?
windrowing of NT
Inflammatory or not?
septic or not?
Inflammatory
septic (intracellular bacteria)
Why is it difficult to diagnose septic joint on cytology?
NT can have significant karyolysis making it look like a macrophage
bacteria predominately marginated on synovium and not in fluid***
Differentials for infectious inflammatory jt fluid?
Of which of the ddx could also be associated with immunologic inflammatory jt fluid?
bacterial (sepsis)
viral, fungal, protozoal, tick-borne, mycoplasma (L form)
BOLD= immunologic also
If you do not see bacteria in joint fluid, it is not septic. T/F?
FALSE
Likely dx?
morula inside NT= anaplasma phagositophilum & erlichia eungii
This kitten presents after a recent vaccination with calicivirus (MLV). He has a fever and joint stiffness + pain. What is your recommendation?
Pain medications & will resolve on own
aka transient arthropathy
What are the most common causes of reactive non-erosive immunologic, inflammatory jt dz?
chronic infection
drug/vax
enteropathy
neoplasia
What is the most common cause of non-erosive polyarthropathy in the canine?
Idiopathic
What immunologic inflammatory condition is associated with CCL rupture?
lymphoplasmacytic
What are the differentials for erosive immunologic, inflammatory joint disease?
Idiopathic (rheumatoid)
Erosive polyarthritis of greyhounds (EPG)
Feline chronic progressive polyarthritis (FCPP)
In what canine breeds is idiopathic erosive inflammatory disease most common aka rheumatoid arthritis?
toy & small breeds
A greyhound presents with joint pain and stiffness in multiple joints and also has a cough. Likely DDX?
Erosive polyarthritis of greyhounds (EPG)
also associated with pneumonia
What gender of felines is more commonly associated with Feline chronic progressive polyarthritis?
males
What viruses are commonly associated with Feline chronic progressive polyarthritis?
FeSFV & ?FeLV
What DDX for non-immunologic inflammatory jt disease?
necrotic neoplasia
Pseudogout (very rare)
