Synoviocentesis

Question 1

Why would we do arthricetesis? (6)

Answer 1

• Joint disease – unknown aetiology
• Joint effusion
• More than one joint affected
• Possible infective arthritis
• Pyrexia of unknown origin
• Monitoring treatment response

Question 2

NAme 3 ways we can do synovial fluid samples

Answer 2

• Direct smear
• EDTA for cell counts, protein lab analyses
• Blood/joint culture medium for culture

Question 3

What do you look at with synovial fluid (6)

Answer 3

• Appearance (clarity + colour)
• Viscosity (polymerisation of hyaluronic acid)
• Mucin clot test (acetic acid)
• Protein
• Nucleated cell count
• Cytology

Question 4

What do you look at with synovial cytology?

Answer 4

• Quality (preservation)
• Cellularity (cell “rowing”, in clusters?)
• Cell population (lymphocytes, neutrophils, neoplastic cells macrophages, synoviocytes, erythrocytes?)
• Cell morphology (size, shape, location and size of nucleus, N/C ratio, cytophagy)
• Background and artefacts

Question 5

How can joint disease be split up into inflammatory and non-inflammatory?

Answer 5

Question 6

If you have a bloody streak in otherwise clear fluid sample of synovial fluid, what is this likely to be?

Answer 6

Traumatic

Question 7

How would you describe this synovial fluid cytology sample?

Answer 7

Normal