Category: Orthopedics
Keywords: Arthrocentesis, Joint, Fluid, Septic (PubMed Search)
Posted: 7/6/2008 by Michael Bond, MD
(Updated: 11/9/2024)
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Joint Fluid Analysis:
This is hte session in Baltimore for crab eating and beer drinking so we begin to see an increase in Gout pain. For those that are presenting with their first episode and you are concerned that they might have a septic joint, I am including this pearl to help analysis the fluid you will obtain from arthrocentesis.
Diagnosis | Appearance | WBC | PMNs | Glucose % of Blood Level | Crystals | |
Normal | Clear | <200 | <25 | 95 - 100 | None | |
Degenerative Joint Disease | Clear | <4000 | <25 | 95 - 100 | None | |
Traumatic Arthritis | Straw colored | <4000 | <25 | 95 - 100 | None | |
Acute Gout | Turbid | 2000 - 50,000 | >75 | 80 - 100 | Negative birefringence | |
PseudoGout | Turbid | 2000 - 50,000 | >75 | 80 - 100 | Positive birefringence | |
Septic Arthritis | Purulent / turbid | 5000 - > 50,000 | >75 | < 50 | None | |
Rheumatoid Arthritis | Turbid | 2000 - 50,000 | 50-75 | ~75 | None |
To view a gout crystal click this link.
To view a pseudogout crystal. Click this link
Pearls:
Benjamin GC. Arthrocentesis. In: Roberts JR, Hedges JR, eds. Clinical procedures in emergency medicine. 3rd ed. Philadelphia: Saunders; 1998:919-932.