scholarly journals The Diagnostic Value of Synovial Fluid Lymphocytes in Gout Patients

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Qidang Huang ◽  
Yukai Huang ◽  
Xin Guo ◽  
Junming Chen ◽  
Zheng Zhong ◽  
...  
Keyword(s):  
Synovial Fluid ◽  
Laboratory Data ◽  
Diagnostic Value ◽  
Youden Index ◽  
Optimal Cutoff ◽  
Cutoff Value ◽  
Synovial Fluid Cell ◽  
Cell Counts ◽  
Synovial Fluid Lymphocytes ◽  
Fluid Cell

Objective. This study is aimed at investigating the diagnostic value of synovial fluid cell counts in gout patients. Methods. A total of 185 gout, 64 rheumatoid arthritis (RA), 26 axial spondyloarthritis (axSpA), and 24 osteoarthritis (OA) patients were included in the study. According to serum uric acid (sUA) levels on attack, gout patients were divided into normal sUA gout patients and high sUA gout patients. The laboratory data were recorded. ROC curves were generated to evaluate the diagnostic value of the variables for gout patients and normal sUA gout patients compared with RA, axSpA, and OA patients. Results. The synovial fluid white blood cell (WBC), peripheral blood mononuclear cell (PBMC), monocyte, polymorphonuclear (PMN), and neutrophil counts in gout patients were higher than those in OA patients ( P < 0.05 ). The synovial fluid PBMC and lymphocyte counts in gout patients were lower than those in RA and axSpA patients ( P < 0.05 ). ROC curve results showed that the AUC values of lymphocytes and sUA for gout patients were 0.728 and 0.881, respectively, which were higher than those of other variables. The optimal cutoff value of lymphocytes for gout was 1.362, with a Youden index of 0.439, a sensitivity of 83.3%, and a specificity of 60.6%. The AUC values of lymphocytes, sUA, and CRP for normal sUA gout patients were 0.694, 0.643, and 0.700, respectively, which were higher than those of other variables. The optimal cutoff value of lymphocytes for normal sUA gout patients was 1.362, with a Youden index of 0.422, a sensitivity of 81.6%, and a specificity of 60.6%. Conclusions. The synovial fluid cell counts of gout patients were different from those of RA, axSpA, and OA patients. Synovial fluid lymphocytes had a higher diagnostic value for gout.

scholarly journals Hip Synovial Fluid Cell Counts in Children From a Lyme Disease Endemic Area

PEDIATRICS ◽  
2018 ◽  
Vol 141 (5) ◽  
pp. e20173810 ◽  
Author(s):  
Arianna H. Dart ◽  
Kenneth A. Michelson ◽  
Paul L. Aronson ◽  
Aris C. Garro ◽  
Thomas J. Lee ◽  
...  
Keyword(s):  
Lyme Disease ◽  
Synovial Fluid ◽  
Endemic Area ◽  
Synovial Fluid Cell ◽  
Cell Counts ◽  
Fluid Cell

Synovial fluid cell count of 84 930/mm3 in adult-onset Still’s disease

2021 ◽  
Vol 14 (8) ◽  
pp. e243889
Author(s):  
Carter Winberg ◽  
Karim Ladak
Keyword(s):  
Synovial Fluid ◽  
Cell Count ◽  
Adult Onset Still’S Disease ◽  
Adult Onset ◽  
Still’S Disease ◽  
Synovial Fluid Cell ◽  
Still's Disease ◽  
Cell Counts ◽  
Fluid Cell ◽  
Adult Onset Still's Disease

In traditional teaching, synovial fluid cell counts over 50 000/mm3 are in keeping with septic or crystalline arthritis. We report a patient with adult-onset Still’s disease (AOSD) and associated inflammatory arthritis whose synovial fluid cell count was over 80 000/mm3. This is the highest level reported in the literature, demonstrating that in the appropriate clinical context, markedly elevated synovial cell count levels over 50 000/mm3 can be caused by inflammatory conditions like AOSD. Recognition of this is crucial to avoid inappropriate antibiotics and procedures while also ensuring correct immunosuppressive treatments are offered in a timely manner.

Proliferation of adherent synovial fluid cell cultures is modified by eicosanoids

Apmis ◽  
1990 ◽  
Vol 98 (7-12) ◽  
pp. 605-608 ◽  
Author(s):  
A. Andreasen ◽  
E. S. Hansen ◽  
K. Fogh ◽  
K. Kragballe ◽  
T. Herlin
Keyword(s):  
Synovial Fluid ◽  
Cell Cultures ◽  
Synovial Fluid Cell ◽  
Fluid Cell

Laboratory investigations in gout

2016 ◽  
Author(s):  
Eliseo Pascual ◽  
Francisca Sivera
Keyword(s):  
Synovial Fluid ◽  
Inflammatory Markers ◽  
Serum Urate ◽  
Calcium Pyrophosphate ◽  
Monosodium Urate ◽  
Renal Handling ◽  
Cell Counts ◽  
Laboratory Investigations ◽  
Fluid Cell ◽  
Methods Of Measurement

Gout is a consequence of hyperuricaemia and the treatment goal is to dissolve the crystals by reducing serum urate levels. The first section of this chapter focuses on laboratory investigations on gout, reviewing serum urate levels and its determinants, methods of measurement, and urate renal handling. Additionally it reviews the use of inflammatory markers and synovial fluid cell counts. The second section of the chapter deals with the identification of monosodium urate and calcium pyrophosphate crystals in synovial fluid. It reviews the use of an optic microscope fitted with polarized filters and an analyser. A clear step-by-step process with useful tips is provided.

scholarly journals Septic Arthritis and the Opioid Epidemic: 1465 Cases of Culture-Positive Native Joint Septic Arthritis From 1990–2018

2020 ◽  
Vol 7 (3) ◽  
Author(s):  
John J Ross ◽  
Kevin L Ard ◽  
Narath Carlile
Keyword(s):  
Staphylococcus Aureus ◽  
Drug Use ◽  
Synovial Fluid ◽  
Septic Arthritis ◽  
Injection Drug Use ◽  
Injection Drug ◽  
Facet Joints ◽  
Cell Counts ◽  
Culture Positive ◽  
Fluid Cell

Abstract Background The clinical spectrum of septic arthritis in the era of the opioid crisis is ill-defined. Methods This is a retrospective chart review of 1465 cases of culture-positive native joint septic arthritis at Boston teaching hospitals between 1990 and 2018. Results Between 1990–2008 and 2009–2018, the proportion of septic arthritis cases involving people who inject drugs (PWID) rose from 10.3% to 20% (P &lt; .0000005). Overall, methicillin-sensitive Staphylococcus aureus (MSSA) caused 41.5% of cases, and methicillin-resistant Staphylococcus aureus (MRSA) caused 17.9%. Gram-negative rods caused only 6.2% of cases. Predictors of MRSA septic arthritis included injection drug use (P &lt; .001), bacteremia (P &lt; .001), health care exposure (P &lt; .001), and advancing age (P = .01). Infections with MSSA were more common in PWID (56.3% vs 38.8%; P &lt; .00001), as were infections with MRSA (24% vs 16.8%; P = .01) and Serratia sp. (4% vs 0.4%; P = .002). Septic arthritis in the setting of injection drug use was significantly more likely to involve the sacroiliac, acromioclavicular, and facet joints; 36.8% of patients had initial synovial fluid cell counts of &lt;50 000 cells/mm3. Conclusions Injection drug use has become the most common risk factor for septic arthritis in our patient population. Septic arthritis in PWID is more often caused by MRSA, MSSA, and Serratia sp., and is more prone to involve the sacroiliac, acromioclavicular, sternoclavicular, and facet joints. Synovial fluid cell counts of &lt;50 000 cells/mm3 are common in culture-positive septic arthritis.

scholarly journals Whole blood aggregometry prior to Pipeline embolization device treatment of intracranial aneurysms: defining an optimal platelet inhibition cutoff value for clopidogrel

2019 ◽  
Vol 131 (5) ◽  
pp. 1437-1444 ◽  
Author(s):  
Paul M. Foreman ◽  
Alejandro Enriquez-Marulanda ◽  
James H. Mooney ◽  
Philip G. R. Schmalz ◽  
Christoph J. Griessenauer ◽  
...  
Keyword(s):  
Antiplatelet Therapy ◽  
Whole Blood ◽  
Intracranial Aneurysms ◽  
Characteristic Curve ◽  
Laboratory Data ◽  
Thromboembolic Complications ◽  
Optimal Cutoff ◽  
Pipeline Embolization Device ◽  
Cutoff Value ◽  
Whole Blood Aggregometry

OBJECTIVEDual antiplatelet therapy is required for the treatment of intracranial aneurysms with the Pipeline embolization device (PED). Platelet function testing (PFT) is often used to assess the efficacy of the antiplatelet regimen prior to PED placement. The optimal impedance values for whole blood aggregometry in this setting have not been defined.METHODSA retrospective review of a prospectively maintained database was performed for the years 2011–2015 to identify patients with intracranial aneurysms treated with the PED who underwent pretreatment PFT using whole blood aggregometry. Antiplatelet therapy was not altered based on PFT results; all patients remained on standard doses of aspirin and clopidogrel. Clinical, radiographic, and laboratory data were analyzed to identify the optimal cutoff impedance value for clopidogrel responsiveness using the receiver operating characteristic curve and Youden’s index.RESULTSForty-nine patients underwent 53 endovascular procedures for the treatment of 76 aneurysms using the PED. The majority of these aneurysms were located in the anterior circulation (90.8%) and affected the internal carotid artery (89.5%). Patients in 30 procedures (56.6%) were identified as clopidogrel responders based on the manufacturer cutoff value (< 6 Ω). Thromboembolic complications occurred in 13 (24.5%) procedures; patients in 6 (11.3%) cases were symptomatic and those in 3 (5.7%) cases had ischemic strokes. Eleven of the 13 (84.6%) thromboembolic complications occurred in clopidogrel nonresponders. An impedance value of ≥ 6 Ω was independently associated with thromboembolic complications. The optimal electrical impedance value was identified as ≥ 6 Ω (sensitivity 84.6%, specificity 70.0%, area under the curve 0.77) for identifying clopidogrel nonresponders.CONCLUSIONSThromboembolic complications are more common following PED placement in patients who do not respond adequately to clopidogrel. Clopidogrel nonresponders can be identified using pretreatment whole blood aggregometry. The optimal cutoff value to categorize a patient as a clopidogrel nonresponder when using whole blood aggregometry is ≥ 6 Ω.

Methods of assessing the synovial fluid cell count

1984 ◽  
Vol 3 (3) ◽  
pp. 319-322 ◽  
Author(s):  
D. O. Haskard ◽  
P. A. Revell
Keyword(s):  
Synovial Fluid ◽  
Cell Count ◽  
Synovial Fluid Cell ◽  
Fluid Cell
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