Joint-Fluid Crystal 

Joint-Fluid Crystal 

No Results

No Results

processing….

Gout and pseudogout are the 2 most common crystalline arthropathies and are caused by deposition of monosodium urate (MSU) and calcium pyrophosphate dihydrate (CPPD) crystals, respectively. This causes inflammation, pain, and destruction of the joint. These 2 pathologies are often diagnosed clinically but can only be done so with certainty by microscopic analysis of synovial fluid.

A normal joint fluid aspirate is negative for any crystals.

Some other parameters for joint fluid reference ranges are as follows:

Synovial appearance (clear)

Synovial color (pale yellow)

Synovial RBC count (0-2000/µL)

Synovial nucleated cell count (13-180/µL)

Synovial neutrophil (0-25%)

Synovial lymphocyte (0-78%)

Synovial monocytes/macrophages (0-71%)

Note that the exact ranges can vary per lab.

Diagnosis of crystalline arthropathy like gout and pseudogout is often clinical. However, they can be confirmed with the aid of joint-fluid analysis.

See the list below:

As seen under the microscope, monosodium urate (MSU) crystals are long, thin and pointed, and are negatively birefringent. These may be within the cell, outside the cell, or within tophi.

White blood cell counts in the synovial fluid are usually within the inflammatory range of 10,000-20,000/µL.

See the list below:

Calcium pyrophosphate dihydrate (CPPD) are shorter and less sharp than MSU crystals. In contrast, they are positively birefringent under polarized light. Crystals can be within or outside the cell.

White blood cell counts in the synovial fluid are usually within the inflammatory range of 10,000-20,000/µL.

Infection in the joint should always be in the differential when considering gout and pseudogout, so the fluid should be sampled sterilely and sent for gram stain and culture. [1]

See the list below:

Specimen type – Synovial fluid from joint

Container – Any sterile container such as that used for urinalysis. (Joint fluid needs no additive in the container.)

Collection method – Sterile needle aspiration (Sterile collection also allows the fluid to be sent for culture as well, depending on clinical suspicion for infection. Lastly, it minimizes risk of introducing bacteria into the joint.)

Specimen volume – At least 1 mL

Related tests are as follows:

Gram stain

Culture and sensitivity

Cell count

Cell differentiation

Color and character

Gout and pseudogout are the 2 most common crystalline arthropathies and are caused by deposition of monosodium urate (MSU) and calcium pyrophosphate dihydrate (CPPD) crystals, respectively. This causes inflammation, pain, and destruction of the joint. These 2 pathologies are often diagnosed clinically. Some have advocated for ultrasound to play a role in the screening process. [2] However, the criterion standard of diagnosis is still microscopic analysis of synovial fluid. Lastly, these crystals have been found in other inflammatory arthritides such as rheumatoid arthritis but still have an unknown role. [3]

. Hammert, Warren C. ASSH Manual of Hand Surgery. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2010. Print.

Lamers-Karnebeek FB, Van Riel PL, Jansen TL. Additive value for ultrasonographic signal in a screening algorithm for patients presenting with acute mono-/oligoarthritis in whom gout is suspected. Clin Rheumatol. Feb 9 2014. Epub ahead of print:

Theiler G, Quehenberger F, Rainer F, Neubauer M, Stettin M, Robier C. The detection of calcium pyrophosphate crystals in the synovial fluid of patients with rheumatoid arthritis using the cytospin technique: prevalence and clinical correlation. Rheumatol Int. Jan 2014. 34(1):137-9.

Tyler Street, MD Resident Physician, Department of Plastic Surgery, The Warren Alpert Medical School of Brown University

Tyler Street, MD is a member of the following medical societies: Alpha Omega Alpha, American Society of Plastic Surgeons

Disclosure: Nothing to disclose.

Scott T Schmidt, MD Clinical Assistant Professor, Department of Surgery, The Warren Alpert Medical School of Brown University; Director of Hand Surgery, Assistant Program Director, Director of Microsurgical Resident Training Lab, Department of Plastic Surgery, Rhode Island Hospital

Disclosure: Nothing to disclose.

Eric B Staros, MD Associate Professor of Pathology, St Louis University School of Medicine; Director of Clinical Laboratories, Director of Cytopathology, Department of Pathology, St Louis University Hospital

Eric B Staros, MD is a member of the following medical societies: American Medical Association, American Society for Clinical Pathology, College of American Pathologists, Association for Molecular Pathology

Disclosure: Nothing to disclose.

Joint-Fluid Crystal 

Research & References of Joint-Fluid Crystal |A&C Accounting And Tax Services
Source

30 thoughts on “Joint-Fluid Crystal 

  1. Pingback: Ts911
  2. Pingback: Zur Webseite
  3. Pingback: meso fat
  4. Pingback: Fun88
  5. Pingback: 바카라사이트
  6. Pingback: fifaqq
  7. Pingback: granice.info
  8. Pingback: Drogen kaufen
  9. Pingback: cai nha cai
  10. Pingback: Melanie Bowen
  11. Pingback: m88 moi nhat
  12. Pingback: sahabatqq
  13. Pingback: bóng88
  14. Pingback: qiuqiu 99
  15. Pingback: look at here
  16. Pingback: Beard Oil
  17. Pingback: hondaqq1
  18. Pingback: ratu capsa

Leave a Reply