A 25 year old professional football is in a car accident His

A 25 year old professional football is in a car accident. His recovery is complete except for persistent knee swelling, for which he has had corticosteroid injections. An arthrocentesis is scheduled.

Blood Chemistry Results: Microbiology: No organisms seen

Glucose: 95 mg/dl Crystals: Few needle shaped crystals

Uric Acid: 5.7 mg/dl Negative birefringence

Synovial Fluid Results: Color:

Yellow Leukocyte Count: 950 cells/ul

Clarity: slightly cloudy Differential Count:

Glucose: 80 mg/dl

Monocytes: 65%

Uric Acid: 5.9 mg/dl

Lymphocytes: 17%

Total Protein: 5.3 mg/dl

Neutrophils: 18%

Lactate: 21 mg/dl (Hint - look at presence of crystals first, then WBC count including neutrophils, and then look at chemistry results.) Based on the results obtained, what type of disease should the synovial fluid specimen be classified as?

Solution

The following are the characteristics of a typical non-inflammatory synovial fluid disease:

a. Appearance: Clear, yellow

b. WBC count: less than 2000 cells/ul

c. PMNs: Less than 25%.

d. Viscosity: High

e. Glucose level: Similar to patient\'s serum glucose level.

So the correct answer is option a.