Joint flid analysis-A study to early diagnose different arthopathies

Introduction: Arthritis is the initial manifestation of many joint disorders. An analysis of synovial fluid has long been recommended as a routine procedure to assist in the diagnosis of arthritis. Objective: The present study was undertaken to correlate the clinical presentation and the results of synovial fluid analysis in arthritic conditions. Materials and Methods: In the present study, A total of 78 joint cases were studied. The joints aspirated were the knee (75 cases), ankle (2 cases) and elbow (1 case). Based on the physical, cytological, biochemical and bacteriological studies, the synovial fluids were divided into distinct group, which confirmed to the clinical diagnostics. Results: In our study of 78 specimens of synovial fluid of various arthritis (synovitis), 24 (30.76%) were osteoarthriitis, 4 (5.12%) were Rheumatoid arthritis, 7 (8.97%) were tuberculous arthritis, 3 (3.84%) were septic arthritis, 1 (1.28%) were neuropathic joint, 10 (12.82%) were Traumatic Joint, 1 (1.28%) was Gouty arthritis, 1 (1.28%) was Rheumatic Fever and 27 (34.61 %) were non-specific synovitis. The synovial glucose values ranged from 35 to 110 mgldl. The total protein content varied from 4 to 6 mgldl. The cytology showed total inflammatory cells varying between 15 cells to 2000 cells / cu.mm. There are predominance of polymorphs, lymphocytes and monocytes. Other cells present were synovial cells. The next most common diagnosis was osteoarthritis (24 cases). Seven cases were diagnosed as tuberculous arthritis. In that four cases were confirmed with synovial biopsy after the synovial analysis. Three cases were diagnosed as septic arthritis. Total four cases diagnosed as rheumatoid arthritis. The series also included one case of rheumatic fever. One case was diagnosed as neuropathic joint involving left elbow the patient presented with gross swelling, pain free joint movement, deformity, thickenings of the synovium and crepitations were present. One case was diagnosed as gouty arthritis. Ten cases were diagnosed as traumatic arthritis. Conclusion: Biochemical analysis and cytology assessment of synovial fluid for proteins and sugar contributes in diagnosis of different types of arthritis.