Synovial fluid analysis in diagnosis of joint diseases

Synovial fluid analysis is one of the most important diagnostic tests in Medicine. Yet it is not routinely practiced in most of the laboratories. Microscopic analysis for the number and type of cells, as well as presence or absence of crystals is equally important. The addition of bacteriological, chemical and immunological tests further enhances the ability to discriminate between vast number of disorders that affect the knee. The present study is taken to examine fresh synovial fluid aspirates with standard protocol of gross and microscopic examination with wet mount preparations to specify the cytomorphological features of abnormal synovial fluid. 100 samples of synovial fluid were analysed which included gross examination, wet mount preparation, total leukocyte count and permanent preparations. Biopsy correlation was available in 25 cases. Of the 100 synovial fluids analyzed, osteoarthritis was seen in 20 cases, rheumatoid arthritis in15, traumatic arthritis in 9, septic arthritis in 5, tuberculous arthritis in 5, pigmented villonodular synovitis in 2, gout in 1, inflammatory arthritis - Not Otherwise Specified (NOS) in 22 and non-inflammatory arthritis - NOS in14. Aspirate was non-diagnostic in 7 cases. Biopsy in 25 cases were Rheumatoid arthritis-07, Chronic nonspecific synovitis-07, Tuberculous arthritis-05, Septic arthritis-02, Pigmented Villonodular Synovitis -02 and Osteoarthritis -2 cases.