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
- 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