week 5 objective
Post on 19-Oct-2014
272 views
DESCRIPTION
TRANSCRIPT
![Page 1: Week 5 objective](https://reader033.vdocument.in/reader033/viewer/2022061105/5443e3a9b1af9f600a8b46d3/html5/thumbnails/1.jpg)
Synovial fluid analysis Sarah
![Page 2: Week 5 objective](https://reader033.vdocument.in/reader033/viewer/2022061105/5443e3a9b1af9f600a8b46d3/html5/thumbnails/2.jpg)
Normal synovial fluid
Normal synovial fluid is: • An ultra-filtrate of plasma • Has no clotting factors • Is viscous • Is acellular • Is aparticulate
![Page 3: Week 5 objective](https://reader033.vdocument.in/reader033/viewer/2022061105/5443e3a9b1af9f600a8b46d3/html5/thumbnails/3.jpg)
Why do we do it ?
1. Helps in referring the patient to the right specialist : non-inflammatory : orthopedic , inflammatory : rheumatology
2. Diagnosis : inflammatory vs non-inflammatory , crystals vs exacerbations , prosthetic failure
3. Prognosis : stage of particular disease , orthopedic intervention
4. Monitor therapy 5. Research
![Page 4: Week 5 objective](https://reader033.vdocument.in/reader033/viewer/2022061105/5443e3a9b1af9f600a8b46d3/html5/thumbnails/4.jpg)
Examining the SF specimen
• Gross analysis • Nucleated cell count • The “wet prep” • Preparation and examination of the stained
cell monolayer
![Page 5: Week 5 objective](https://reader033.vdocument.in/reader033/viewer/2022061105/5443e3a9b1af9f600a8b46d3/html5/thumbnails/5.jpg)
Gross analysis
• Color Haemorrhagic episode : trauma , mild trauma in antico- agulant therapy, bleeding due to pigmented villonodular synovitis. • Clarity Cloudy / opaque appearance indicates presence of crystals , proteins , lipids , increased cellular components • Viscosity
![Page 6: Week 5 objective](https://reader033.vdocument.in/reader033/viewer/2022061105/5443e3a9b1af9f600a8b46d3/html5/thumbnails/6.jpg)
Nucleated cell count
• The number of nucleated cells contained in the SF is a prime indicator of inflammation.
• Cell count is less than 500/ mm3 the patient can be assumed to have a non-inflammatory arthropathy
• Cell count is greater than 1500 this would indicate an inflammatory arthropathy.
![Page 7: Week 5 objective](https://reader033.vdocument.in/reader033/viewer/2022061105/5443e3a9b1af9f600a8b46d3/html5/thumbnails/7.jpg)
The “wet prep”
• It is basically used to identify crystals and debris
![Page 8: Week 5 objective](https://reader033.vdocument.in/reader033/viewer/2022061105/5443e3a9b1af9f600a8b46d3/html5/thumbnails/8.jpg)
Crystals Using polarizing microscopy
MSU CPPD
bright birefringent crystals that are yellow (negatively birefringent)
shorter rod shape and often they are rhomboidal or cube shaped. They are.
![Page 9: Week 5 objective](https://reader033.vdocument.in/reader033/viewer/2022061105/5443e3a9b1af9f600a8b46d3/html5/thumbnails/9.jpg)
Preparation and examination of the stained cell monolayer
Using gram-stain of cytological stains to identify cells and organisms
![Page 10: Week 5 objective](https://reader033.vdocument.in/reader033/viewer/2022061105/5443e3a9b1af9f600a8b46d3/html5/thumbnails/10.jpg)
![Page 11: Week 5 objective](https://reader033.vdocument.in/reader033/viewer/2022061105/5443e3a9b1af9f600a8b46d3/html5/thumbnails/11.jpg)