II. Indication

  1. Single most important test in Arthritis evaluation

III. Preparation

  1. Heparinized Tube for crystal analysis
  2. Saline Tube for Cell Count

IV. Synovial Fluid Volume and Appearance

  1. Normal Synovial Fluid
    1. Slightly yellow, straw colored
    2. Clear (Can read newsprint through the fluid)
    3. Viscous consistency
    4. No clotting
  2. Inflammatory fluid
    1. Yellow green to gray
    2. Cloudy to Opaque
    3. Decreased viscosity to Watery consistency
  3. Findings suggestive of acute Fracture or derangement
    1. Large fat droplets (sensitive for Fracture)
    2. Bloody fluid

V. Synovial Fluid Gram Stain and Culture

  1. Bacteria (Anaerobes if arthroplasty)
  2. Mycobacteria, Fungal Culture on tissues

VI. Other Specific Synovial Fluid Tests

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