scholarly journals The value of synovial fluid analysis in the assessment of knee joint destruction in arthritis in a three year follow up study

1999 ◽  
Vol 58 (9) ◽  
pp. 559-562 ◽  
Author(s):  
S Aman ◽  
J Risteli ◽  
R Luukkainen ◽  
L Risteli ◽  
M Kauppi ◽  
...  
Keyword(s):  
Synovial Fluid ◽  
Knee Joint ◽  
Joint Destruction ◽  
Follow Up Study ◽  
Fluid Analysis ◽  
Synovial Fluid Analysis

scholarly journals A hospital based cross sectional study on synovial fluid analysis among patients with different types of knee joint disorders at a tertiary care hospital

2018 ◽  
Vol 4 (6) ◽  
pp. 959
Author(s):  
Arvind Gandra
Keyword(s):  
Synovial Fluid ◽  
Knee Joint ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cross Sectional ◽  
Fluid Analysis ◽  
Synovial Fluid Analysis ◽  
Different Types

<p class="abstract"><strong>Background:</strong> Patients presenting with knee joint disorders are subjected to variety of investigations which are often inconclusive. Instead if they are subjected for synovial fluid analysis, they will be benefited. The objective of the study was to study synovial fluid analysis among patients with different types of knee joint disorders at a tertiary care hospital.</p><p class="abstract"><strong>Methods:</strong> A hospital based cross sectional study was carried out among 30 patients attending the outpatient Department of Orthopedics and suffering from knee joint pain of either left or right or both the sides. Present study was carried out over a period of two years from January 2011 to December 2012 at Department of Orthopedics, Global Hospitals, Secunderabad. All patients were examined in detail and subjected to all necessary investigations.<strong></strong></p><p class="abstract"><strong>Results:</strong> Males were more than females. The most common joint disease in the study population was tubercular synovitis in 20% of the cases. The most common condition among males was osteoarthritis while there was no such case in females. Rheumatoid arthritis was most common in females while there was no such case in males. Polymorphs were seen in all cases except osteoarthritis and villonodular synovitis. On biochemical analysis of synovial fluid it was found that gouty arthritis did not have proteins. Proteins were minimum in the synovial fluid in case of osteoarthritis while maximum range was found in cases of tubercular arthritis and rheumatoid arthritis.</p><p class="abstract"><strong>Conclusions:</strong> Synovial fluid analysis is very important to understand the etiopathogenesis of knee joint diseases. Our study showed that synovial fluid of the knee joint analysis was very informative in the diagnosis and proper management of the patients presenting with knee joint disorders.</p>

scholarly journals AB0629 ACCURACY OF SYNOVIAL FLUID ANALYSIS FOR THE IDENTIFICATION OF CALCIUM PYROPHOSPHATE CRYSTALS: AN ANCILLARY STUDY OF OMERACT CRITERION VALIDITY STUDY FOR ULTRASOUND IN CPPD

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1348.1-1348
Author(s):  
A. Adinolfi ◽  
S. Sirotti ◽  
M. Gutierrez ◽  
C. Pineda ◽  
D. Clavijo Cornejo ◽  
...  
Keyword(s):  
Synovial Fluid ◽  
Diagnostic Accuracy ◽  
Light Microscopy ◽  
Hyaline Cartilage ◽  
Microscopic Analysis ◽  
Calcium Pyrophosphate ◽  
Ancillary Study ◽  
Fluid Analysis ◽  
Synovial Fluid Analysis ◽  
Sensitivity Specificity

Background:Synovial fluid analysis (SFA) via compensated polarized light microscopy is still considered the gold standard for the identification and diagnosis of Calcium Pyrophosphate Deposition disease (CPPD)-related arthropathies[1], but very few studies have been published about its diagnostic accuracy.Objectives:The aim of this study was to evaluate the accuracy of SFA in the identification of calcium pyrophosphate dihydrate (CPP) crystals compared to microscopic analysis of joint tissues as the reference standard.Methods:This is an ancillary study of an international, multicentre cross-sectional study performed by the CPPD subgroup of the OMERACT Ultrasound working group[2]. Consecutive patients with knee osteoarthritis (OA) waiting for total knee replacement surgery were enrolled in the study from 2 participating centres, Mexico and Romania. During surgical procedures synovial fluid (SF), menisci and hyaline cartilage were collected and analysed within 48 hours after surgery under transmitted light microscopy and compensated polarised light microscopy for the presence/absence of CPP crystals. All slides were analysed by expert examiners on site, blinded to other findings. A dichotomic score (absence/presence) was used for scoring both SF and tissues. Microscopic analysis of knee tissues was considered the gold standard. Sensitivity, specificity, accuracy, positive and negative predictive values (PPV and NPV) of SFA in the identification of CPP crystals were calculated.Results:15 patients (53% female, mean age 68yo ± 8.4) with OA of grade 3 or 4 according to Kellgren-Lawrence scoring were enrolled. 12 patients (80%) were positive for CPP crystals at SFA and 14 (93%) at tissues microscopic analysis. Among 12 SFA positive patients, all were positive for CPP crystals in either medial or lateral meniscus, and 11 were positive in both; 10 patients were positive at the hyaline cartilage, and all 10 were also positive for at least one meniscus. Regarding the 3 SFA negative patients, only one had no crystals in the examined tissues, while the other 2 patients had CPP crystals in both menisci and hyaline cartilage. The overall diagnostic accuracy of SFA compared to histology analysis for CPPD was 87%, with a sensitivity of 86% and a specificity of 100%, the PPV was 100% and the NPV was 33% (Table 1).Table 1.sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy of synovial fluid analysis compared to the reference standard. CI: Confidential Interval. SF: synovial fluid, in parentheses: numerators and denominators for all percentages provided.SensitivitySpecificityPPVNPVAccuracySF analysis86% (12/14)100% (1/1)100% (12/12)33% (1/3)87% (13/15)(0.65-0.99) CI 95%(0.0-0.25) CI 95%(0.65-0.99) CI 95%(0.0-0.25) CI 95%Conclusion:SFA demonstrated to be an accurate test for the identification of CPP crystals in patients with advanced OA. However, is not always feasible and carries some risks for the patient. Considering the availability of validated imaging techniques for the detection of CPPD, such as US, SFA could be used in those patients where imaging and clinical data are not definitely confirmatory of the disease.References:[1]W. Zhang et al., ‘European League Against Rheumatism recommendations for calcium pyrophosphate deposition. Part I: terminology and diagnosis’, Ann Rheum Dis, vol. 70, no. 4, pp. 563–570, Apr. 2011, doi: 10.1136/ard.2010.139105.[2]G. Filippou et al., ‘Criterion validity of ultrasound in the identification of calcium pyrophosphate crystal deposits at the knee: an OMERACT ultrasound study’, Ann Rheum Dis, p. annrheumdis-2020-217998, Sep. 2020, doi: 10.1136/annrheumdis-2020-217998.Disclosure of Interests:None declared.

scholarly journals Lyme Arthritis: A Comparison of Presentation, Synovial Fluid Analysis, and Treatment Course in Children and Adults

2013 ◽  
Vol 65 (12) ◽  
pp. 1986-1990 ◽  
Author(s):  
Brian E. Daikh ◽  
Fred E. Emerson ◽  
Robert P. Smith ◽  
F. Lee Lucas ◽  
Carol A. McCarthy
Keyword(s):  
Synovial Fluid ◽  
Lyme Arthritis ◽  
Fluid Analysis ◽  
Synovial Fluid Analysis

Synovial fluid D-dimer concentration in horses with osteochondritis dissecans and osteoarthritis

2013 ◽  
Vol 26 (01) ◽  
pp. 54-60 ◽  
Author(s):  
L. Monreal ◽  
M. A. Delgado ◽  
J. Ríos ◽  
M. Prades ◽  
T. Ribera
Keyword(s):  
Clinical Study ◽  
Synovial Fluid ◽  
Clinical Significance ◽  
Osteochondritis Dissecans ◽  
Surgical Procedure ◽  
Fluid Analysis ◽  
Synovial Fluid Analysis ◽  
Pathway Activation ◽  
D Dimer ◽  
Coagulation And Fibrinolysis

Summary Objective: To assess the synovial fibrinolytic pathway activation in adult horses with developmental and degenerative arthropathies such as osteochondritis dissecans (OCD) and osteoarthritis (OA) by measuring synovial D-dimer concentrations. Methods: Prospective observational clinical study of horses admitted for OCD or OA. Synovial fluid was collected during lameness examination or prior to the surgical procedure, and D-dimer concentration and routine synovial fluid analysis were performed. Results: Fifty-eight horses (14 with OCD, 10 with OA and 34 controls) were included in this study. Synovial D-dimer concentrations of horses with OCD and OA were both higher when compared with controls, but were only significantly different in horses with OCD (p = 0.005). However, no statistical differences were observed when comparing synovial D-dimer concentrations from the OCD horses with the OA-affected horses (p = 0.444). Clinical significance: Activation of coagulation and fibrinolysis play a role in the pathophysiology of equine OCD and OA.

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