II. Indications
- Single most important test in Arthritis evaluation
- Septic Joint
- Crystal-Induced Arthritis (e.g. Gouty Arthritis, Pseudogout)
III. Contraindications
- Overlying infection (unable to access joint without passing through infected tissue)
IV. Preparation
- Ultrasound
- Tubes
- Heparinized Tube for crystal analysis
- Saline Tube for Cell Count
- Culture container
- Syringe (20 cc)
- Aspiration Needle
- Adequate guage (18-22 gauge) to aspirate Synovial Fluid
- Adequate Length (1.5" for superficial joints, 3.5" spinal needle for deeper joints)
-
Skin Preparation
- Lidocaine 1% with Epinephrine
- Chlorhexidine (or Betadine) skin antiseptic
- Sterile drape
V. Procedure: Arthrocentesis
VI. Labs: Synovial Fluid Volume and Appearance
- Normal Synovial Fluid
- Slightly yellow, straw colored
- Clear (Can read newsprint through the fluid)
- Viscous consistency
- No clotting
- Inflammatory fluid
- Yellow green to gray
- Cloudy to Opaque
- Decreased viscosity to Watery consistency
- Findings suggestive of acute Fracture or derangement
- Large fat droplets (sensitive for Fracture)
- Bloody fluid
VII. Labs: Synovial Fluid Gram Stain and Culture
- Bacteria (Anaerobes if arthroplasty)
- Mycobacteria, Fungal Culture on tissues
VIII. Labs: Other Specific Synovial Fluid Tests
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Related Studies
| Definition (FMA) | Transudate contained in the synovial cavity of joints, and in the cavity of tendon sheaths and bursae. |
| Definition (MSHCZE) | Kloubní maz. Viskózní tekutina, která má význam pro vzájemný pohyb kloubních ploch a omezení jejich tření. Je produkována synoviální blankou (membrana synovialis, zkráceně synovialis), která tvoří součást výstelky kloubu (vnitřní vrstva kloubního pouzdra). Její vlastnosti se mění u některých kloubních onemocnění. V některých případech se s. blanka chirurgicky odstraňuje (synovektomie). Ve složení se uplatňují některé mukopolysacharidy, např. hyaluronová kyselina, která se rovněž dodává jako lék. (cit. Velký lékařský slovník online, 2012 http://lekarske.slovniky.cz/ ) |
| Definition (UWDA) | Transudate contained in the synovial cavity of joints, and in the cavity of tendon sheaths and bursae. |
| Definition (NCI_CDISC) | A viscid fluid secreted by the synovial membrane, serving as a lubricant. (NCI) |
| Definition (NCI) | A viscid fluid secreted by the synovial membrane, serving as a lubricant. |
| Definition (MSH) | The clear, viscous fluid secreted by the SYNOVIAL MEMBRANE. It contains mucin, albumin, fat, and mineral salts and serves to lubricate joints. |
| Definition (CSP) | clear, viscous fluid secreted by the synovial membrane; contains mucin, albumin, fat, and mineral salts and serves to lubricate joints. |
| Concepts | Body Substance (T031) |
| MSH | D013582 |
| SnomedCT | 6085005, 431898009, 145105008, 167878001 |
| HL7 | SYN |
| LNC | LA13477-7 |
| English | Fluid, Synovial, Fluids, Synovial, Synovial Fluids, Synovia, Synovial fluid: joint NOS, Joint fluid (substance), Joint fluid, Synovial Fluid, fluid synovial, fluid joints, fluids synovial, fluid joint, fluid joints synovial, synovial fluids, synovial fluid, joint fluid, synovia, Synovial fluid: joint NOS (specimen), FLUID, SYNOVIAL, SYNOVIAL FLUID, Synovial fluid, Synovial fluid (substance) |
| French | Liquide synovial, Synovie |
| Swedish | Ledvätska |
| Czech | synoviální tekutina, kloubní maz, synovie |
| Finnish | Nivelvoide |
| Russian | SINOVIAL'NAIA ZHIDKOST', SINOVIIA, СИНОВИАЛЬНАЯ ЖИДКОСТЬ, СИНОВИЯ |
| Japanese | 滑液, 関節液 |
| Spanish | líquido articular, líquido articular (sustancia), líquido sinovial: articulación, SAI (espécimen), Synovial fluid: joint NOS, líquido sinovial: articulación, SAI, aceite articular, líquido sinovial (sustancia), líquido sinovial, Líquido Sinovial, Sinovia |
| Italian | Sinovia, Liquido sinoviale |
| Croatian | SINOVIJSKA TEKUĆINA |
| Latvian | Sinoviālais šķidrums, Sinovijs |
| Polish | Maź stawowa, Płyn maziowy |
| Norwegian | Synovia, Synovialvæske, Leddvæske |
| German | Gelenkschmiere, Synovia, Synovialflüssigkeit |
| Dutch | Synovia, Synoviaal vocht, Vocht, synoviaal |
| Portuguese | Líquido Sinovial, Sinóvia |
Ontology: Synovial fluid analysis (C0200648)
| Concepts | Laboratory Procedure (T059) |
| SnomedCT | 167906002, 167860006, 167865001, 145088009, 145133008, 145092002, 145087004, 167859001, 85396007 |
| Italian | Analisi del liquido sinoviale |
| English | Synovial fluid exam. - general, Synovial fluid exam. NOS, Synovial fluid exam. gen. NOS, synovial fluid analysis (lab test), synovial fluid analysis, analysis fluid synovial, synovial fluid exam, exam fluid synovial, Synovial fluid examination NOS, Synovial fluid examination NOS (procedure), Synovial fluid examination - general (procedure), Synovial fluid examination general NOS, Synovial fluid exam. gen. NOS (procedure), Synovial fluid exam. - general (procedure), Synovial fluid examination - general, Synovial fluid examination general NOS (procedure), Synovial fluid exam. NOS (procedure), Synovial fluid examination, Synovial fluid analysis, Synovial fluid analysis (procedure), Synovial fluid examination (procedure), Synovial fluid analysis, NOS |
| Japanese | 滑液検査, ｶﾂｴｷｹﾝｻ |
| Czech | Analýza synoviální tekutiny |
| Hungarian | Synovialis folyadék elemzés |
| Spanish | Synovial fluid exam. NOS, examen de líquido sinovial, general, examen de líquido sinovial, SAI, examen de líquido sinovial, SAI (procedimiento), examen general de líquido sinovial, SAI, examen de líquido sinovial, general (procedimiento), examen general de líquido sinovial, SAI (procedimiento), análisis del líquido sinovial (procedimiento), análisis del líquido sinovial, examen de líquido sinovial (procedimiento), examen de líquido sinovial, Análisis de líquido sinovial |
| Portuguese | Análise do fluido sinovial |
| Dutch | synoviaal vocht analyse |
| French | Analyse du liquide synovial |
| German | Synovialanalyse |
Ontology: Arthrocentesis (C0204854)
| Concepts | Therapeutic or Preventive Procedure (T061) |
| ICD9 | 81.91 |
| SnomedCT | 55599005, 179921001, 90131007, 179906007 |
| English | Arthrocentesis, Puncture of joint NOS, arthrocentesis with aspiration of joint (treatment), arthrocentesis with aspiration of joint, aspiration of a joint, Aspiration joint, Joint aspiration, joint aspiration, Aspiration;joint(s), aspiration of joint, aspirations joint, Puncture of joint NOS (procedure), Aspiration of joint (procedure), Aspiration of joint, Puncture of joint, Puncture of joint (procedure), Arthrocentesis (procedure), Tap of joint, Arthrocentesis, NOS, Aspiration of joint, NOS, Puncture of joint, NOS, Tap of joint, NOS, Aspiration of joint -RETIRED-, arthrocentesis, aspiration of the joint(s) |
| Italian | Aspirazione di articolazione, Artrocentesi, Aspirazione articolare |
| Dutch | aspiratie van gewricht, gewrichtsaspiratie, artrocentese, aspiratie gewricht |
| French | Arthrocentèse, Aspiration articulaire, Ponction articulaire |
| German | Arthrozentese, Gelenkaspiration, Aspiration eines Gelenks, Aspiration Gelenk |
| Portuguese | Aspiração articular, Artrocentese, Aspiração de articulação |
| Spanish | Artrocentesis, Aspiración de articulación, punción articular, SAI, aspiración articular - RETIRADO -, punción articular, SAI (procedimiento), aspirado de articulación, aspiración articular - RETIRADO - (concepto no activo), artrocentesis (procedimiento), artrocentesis, aspiración de una articulación, punción articular (procedimiento), punción articular, punción de una articulación, Aspiración articular |
| Japanese | 関節穿刺, 関節吸引, ｶﾝｾﾂｾﾝｼ, ｶﾝｾﾂｷｭｳｲﾝ |
| Czech | Aspirace kloubu, Aspirace z kloubu, Artrocentéza |
| Hungarian | Ízületi aspiracio, Ízületi aspiratio, Ízület aspiratio, Arthrocentesis |
