Synovial Fluid Analysis- Parks Flashcards
What color is normal synovial fluid?
Clear
What are the three things you look at with synovial fluid?
- general appearance
- bacteriology
- microscopy
If synovial fluid is white, how would you describe it?
purulent (lots of neutrophils) -> seen in septic arthritis
If synovial fluid is cloudy, what should you be thinking?
lymphocytes?-> could be signs of inflammation, need to check this out, not septic yet.
If synovial fluid is red/brown/orangish (xanothochromia), what should you be thinking?
old degenerating red cells-> old hemmorhage
If your synovial fluid is bright red then what is it?
hemearthrosis (caused by trauma or hemophilia)
What does arthrosis mean?
joint
If you have inflammatory synovial fluid what do you need determine first?
if it is septic arthrosis
If you have a white cell count greater than 100,000 then what is the problem?
septic arthrosis (appears purulent)
If you have a white cell count less than 2000, is it inflammotry or non inflammatory?
noninflammatory, greater than 2000-inflammatory
What is linkd to otitis media?
H. influenza
YOu can get (blank) from gonnorhea, seen in the hands
septic arthritis
DO all septic arthroses present with redness?
no
In septic arthritis you see inflammed (blank)
synovial
Septic arthritis has an increased amount of (blank)
fluid (when doing a needle biopsy, the more fluid you take out the better)
What all do you want to do to they synovial fluid?
Get a: gram stain culture cell count differential
Need to treat septic arthrisis or you can get inflammation which will cause breakage of (blank) resulting in destruction of bone
tissue
What are some causes of hemarthrosis?
- trauma
- bleeding disorders
- villondular synovitis
- charcot joint
- resolving infection
- contamination during aspiration
- pyrophosphate arthropathy
What are causes of pyarthrosis?
- joint sepsis
- crystal synovitis
- rheumatoid arthritis
- inflammatory diseases
WHen you see something purulent what are you thinking?
septic arthritis!!!!!!!
If you have an ulcer that leads to a joint what do you call this?
a fistula or sinus tract
How should you assess a messed up inflammed knee?
take a biopsy from the hemmorhaging messed up tissue
Wht are the most helpful tests in assessing a perioprosthetic joint infection?
A) Syn fld WBC elevated (3450/uL) and greater than 75% polys
B) Elevated ESR and C-reactive protein
A normal CRP ‘generally’means NEG
C) Both fluid and tissue culture
How to assess gout?
get needle aspiration and utilize befringment (shows the needle-like crystals of urate if gout)
Can you assess gout based on uric acid levels?
no because some cases of gout do not have increased uric acid levels
If you see a an circular outpouching in gout, what do you call this?
a tophus
T or F
In some cases of septic arthritis the serum uric acid level is increased.
So what does this mean
T
Do NOT use the serum uric acid level to make the initial dx of acute gouty arthritis.
If you see rhomboid/rectangular cyrstals what is this?
pseudogout AKA calcium pyrophosphate
(blank)can occur after joint trauma, post-surgery and with moderate to severe medical illness
calcium pyrophosphate deposition disease (CPDD aka pseudogout)
What do you call calcification of the meniscus of the knee?
chondro-calcinosis
What causes chondro-calcinosis?
pseudo gout
What are three conditions associated CPDD aka pseudgout?
- Hemochromatosis
- Hyperparathyroidism
- Hypomagnesemia
