Health Questions and Answers

Question: Which studies should generally be performed on synovial fluid after arthrocentesis?


Gram stain and bacterial culture may confirm the presence of an infective agent. In the right clinical setting, similar procedures for mycobacteria or fungi are important. A white blood cell (WBC) count with differential is one of the best indicators of the degree of inflammation. Evaluation for crystals by polarized light microscopy may confirm the diagnosis. Although a good deal has been written about various other tests (e.g., glucose, complement, rheumatoid factor, ANA, lactate dehydrogenase, protein), they add little diagnostic information.

Reference:  Harris ED, Budd RC, Firestein GS, et al (eds): Kelley’s Textbook of Rheumatology, 7th ed. Philadelphia, W.B. Saunders, 2005

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