무릎 관절의 Fluid analysis

Normal synovial fluid : Slightly yellow, straw colored, clear, viscous consistency, no clotting 

Inflammatory fluid : Yellow green to gray, cloudy to Opaque, decreased viscosity to watery consistency 

Important to have flulid send for gram stain and cultures

Bloody : ligament, OCD, fracture 

Serous fluid with some blood : New meniscal injury, small OCD 

Serous : Chronic irritation, old meniscus tear

1. Normal 

1) Synovial fluid less than 200 WBC per mm3 

2) Polymorphonuclear leukocytes less than <50% 

2. Non-inflammatory fluid : 200~2,000WBC/mm3 

1) OA or DJD 

2) Trauma 

3) OCD 

4) Rheumatic fever

5) Chronic gout and Pseudogout 

6) Progressive Systemic Sclerosis 

7) Polymyositis 

8) SLE 

9) Neuropathic arthropathy 

10) Erythema Nodosum

11. Pigmented villnodular synovitis 

12) Hypertrophic osteoarthropathy

3. Non-inflammatory fluid : 2,000~50,000WBC/mm3(mild<20,000) 

1) Rhematoid Arthritis 

2) Psoriatic Arthritis 

3) Ankylosing Spondylitis 

4) Acute Rheumatic Fever 

5) Acute gout and Pseudogout 

6) Progressive Systemic Sclerosis 

7) Polymyositis

8) SLE, Reiter’s Syndrome 

9) Inflammatory Bowel Disease Arthritis 

10) Fungal and Viral infections 

11) Bacterial infections(partially treated)

4. Septic fluid : Over 50,000WBC/mm3(especially>100,000) : Septic Arthritis until proven otherwise