Rheumatology Book

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Synovial Fluid White Blood Cell Count

Aka: Synovial Fluid White Blood Cell Count, Synovial Fluid WBC
  1. Technique
    1. Wright's Stain for cell count with differential
  2. Normal Synovial Fluid
    1. Less than 200 White Blood Cells (WBC) per mm3
    2. Polymorphonuclear Leukocytes (PMN) less than <50%
  3. Non-Inflammatory fluid: 200 - 2000 WBC/mm3
    1. Osteoarthritis or Degenerative Joint Disease
    2. Trauma
    3. Osteochondritis Dissecans
    4. Rheumatic Fever
    5. Chronic gout
    6. Chronic Pseudogout
    7. Progressive Systemic Sclerosis (Scleroderma)
    8. Polymyositis
    9. Systemic Lupus Erythematosus (SLE)
    10. Neuropathic Arthropathy (Hemorrhage may be present)
    11. Erythema Nodosum
    12. Pigmented villonodular synovitis
    13. Hypertrophic Osteoarthropathy
  4. Inflammatory fluid: 2000 - 50,000 WBC/mm3 (mild < 20,000)
    1. Rheumatoid Arthritis
    2. Psoriatic Arthritis
    3. Ankylosing Spondylitis
    4. Acute Rheumatic Fever
    5. Acute gout
    6. Acute Pseudogout
    7. Progressive Systemic Sclerosis (Scleroderma)
    8. Polymyositis
    9. Systemic Lupus Erythematosus (SLE)
    10. Reiter's Syndrome
    11. Inflammatory Bowel DiseaseArthritis
    12. Fungal Infections
    13. Viral Infections
    14. Bacterial Infections (partially treated)
  5. Septic fluid: Over 50,000 WBC/mm3 (especially >100,000)
    1. Septic Arthritis until proven otherwise
  6. Reference
    1. Kolba (1984) Prim Care 11:211-8

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