Routine examination of synovial fluid

Routine examination of synovial fluid is an examination of periosteal fluid. The synovial fluid is located in the joint cavity, also known as joint fluid or synovial fluid. It is filtered by the plasma in the capillaries under the synovial membrane and enters the joint cavity through the synovial membrane. At the same time, the synovial cells also secrete many hyaluronic acid to form a slip. Membrane fluid, to lubricate joints, nutrient cartilage, under normal circumstances, the amount of synovial fluid in the joint cavity is very small, it is not suitable for extraction, even if the large joints such as the knee joint does not exceed 4ml at most, joint diseases caused by various reasons, Increase the permeability of the synovial membrane and capillaries, cause arthritic reactions, change the amount and composition of the synovial fluid, and extract the synovial fluid by joint puncture for analysis, which is of great significance for the diagnosis of joint diseases. Basic Information Specialist classification: growth and development check classification: body fluid examination Applicable gender: whether men and women apply fasting: not fasting Tips: Less exercise to cause trauma or strain before the examination, reduce joint weight and flexion and extension activities. Normal value White blood cells <100×10 6th power/L (<100/mm3). Polymorphonuclear leukocytes <0.25 (<25%). Protein quantification <25 g/L (<2.5 g/dl). Mucin 1 or 2 type. Crystallization 0. Glucose 0.56 mmol/L (10 mg/dl). Clinical significance Abnormal result (1) leukocytosis (200-2000) × 10 6th power / L non-inflammatory arthritis. (2000 to 75000) × 10 6th power / L inflammatory arthritis. >100000×106/L septic arthritis. (2) Polymorphonuclear leukocytes >0.50 inflammatory arthritis. >0.75 septic arthritis (3) protein quantitative rheumatoid arthritis or crystalline synovitis (such as gout) protein quantitatively increased, often 40 ~ 70g / L, degenerative arthritis mildly increased cupping network. (4) Mucin clot formation is poor or brittle, found in inflammatory arthritis, septic arthritis (5) Crystallized gouty arthritis (urate crystals), pseudogout (pyrophosphate crystals), and chronic rheumatoid arthritis (cholesterol crystals). (6) Glucose reduces inflammatory arthritis and septic arthritis. People who need to be checked Patients with rheumatoid arthritis, patients with gouty arthritis, and other patients with chronic rheumatoid arthritis. Precautions Before the examination: less exercise that causes trauma or strain, reduce joint weight and flexion and extension activities. When checking: 1. Orientation In arthroscopic examination, since only a small part of the joint can be seen, it is not easy to judge which part of the joint image belongs to at the beginning of the examination, and the sac between the upper sac and the sac. Upper synovial folds are a good sign and easy to position. 2. Synovial congestion When arthroscopic examination, physical stimulation will affect the visual field, and liquid temperature and hydraulic pressure can also affect blood flow. Therefore, synovial congestion should be regarded as normal after 10 minutes of arthroscopic insertion. 3. Age factors vary with age, the images in the joints are different, the cartilage surface of children is smooth and elastic, the supraorbital sac is smooth, the villi are less, and the adult articular cartilage surface is yellow, rough feathers in adulthood. The shape is more, the meniscus is also the same, the inner edge is meat-like, the synovial fold is more, the villus hyperplasia, the joint capsule is poorly stretched. 4. Internal structure individual differences There are three main types of normal synovial folds, namely, supraorbital synovial folds, medial synovial folds, and sacral membrane folds, all of which are residual parts of the synovial membrane during development. Yes, no one. After the examination: the condition can be alleviated by various therapies such as drugs, massages and the like. Inspection process In the diagnosis and treatment of joint disease development, it is possible to agree to the arthroscopic examination. The video recording or synovial biopsy can obtain data that is difficult to obtain by other diagnostic methods. It is of great help to the diagnosis and prognosis. Some lesions of the knee and shoulder joints can be operated with special instruments under the microscope after careful diagnosis and discharge, and satisfactory results are obtained. Not suitable for the crowd Joint stiffness. Adverse reactions and risks Generally no adverse reactions.