Synovial Fluid Analysis in patients with Primary Osteoarthritis of the Knee Joint
HALA SAMIR AHMED EL BADAWY;
Abstract
Objective :The aim of this work is to detect crystals in the synovial fluid of osteoarthritis of knee joint effusions by polarized light microscopy and alizarin stain. Also this work includes a COJTelative study between the presence of crystals and the different radiological grading of osteoarthritis of the knee joint.
Patients & Methods : Thirty patients suffering from osteoarthritis of
the knee joint with effusion were included in this study. Patients were subjected to a full history taking as well as clinical and laboratory investigations. Plain radiography of the affected joints was done to es ablish the diagnosis and to assess the radiographic scoring of osteoarthritis. Screening for different crystals by alizarin stain using polarized light microscopy was carried out for the aspirated synovial fluid of different joints affected.
Results : Analysis of our results have shown that CPPD crystals were the commonest ones detected as it was found in 14 patients (46%). Hydroxyapatite crysrals using polarized light microscopy were detected in 5 patients (16%). Lipid-liquid crystals were found in 4 patients (13%). Glucocorticoid crystals were found in 2 patients (6%). Fibrils were found in 5 patients (16%). Radiographic scoring of subchondral cyst formation correlates with the amount of effusion and tenderness, while radiographic scoring of joint space narrowing correlates with tenderness only. Conclusion : Patients suffering from chronic painful inflammatory effusion secondary to osteoarthritis should be subjected to taping and examination of the aspirated synovial fluid under light microscopy as well as polarized light microscopy. CPPD crystals can either be seen directly under the polarized light microscopy or after centrifuging of the synovial fluid and staining the precipitate with alizarin stain since these crystals are frequently found in osteoarthritis knee joint effusions. Other crystals such as hydroxyapatite crystals can also be present and detected using polarized light microscopy. Early destruction of the articular cartilage occurs rapidly in patients with positive crystals in their synovial fluid.
Patients & Methods : Thirty patients suffering from osteoarthritis of
the knee joint with effusion were included in this study. Patients were subjected to a full history taking as well as clinical and laboratory investigations. Plain radiography of the affected joints was done to es ablish the diagnosis and to assess the radiographic scoring of osteoarthritis. Screening for different crystals by alizarin stain using polarized light microscopy was carried out for the aspirated synovial fluid of different joints affected.
Results : Analysis of our results have shown that CPPD crystals were the commonest ones detected as it was found in 14 patients (46%). Hydroxyapatite crysrals using polarized light microscopy were detected in 5 patients (16%). Lipid-liquid crystals were found in 4 patients (13%). Glucocorticoid crystals were found in 2 patients (6%). Fibrils were found in 5 patients (16%). Radiographic scoring of subchondral cyst formation correlates with the amount of effusion and tenderness, while radiographic scoring of joint space narrowing correlates with tenderness only. Conclusion : Patients suffering from chronic painful inflammatory effusion secondary to osteoarthritis should be subjected to taping and examination of the aspirated synovial fluid under light microscopy as well as polarized light microscopy. CPPD crystals can either be seen directly under the polarized light microscopy or after centrifuging of the synovial fluid and staining the precipitate with alizarin stain since these crystals are frequently found in osteoarthritis knee joint effusions. Other crystals such as hydroxyapatite crystals can also be present and detected using polarized light microscopy. Early destruction of the articular cartilage occurs rapidly in patients with positive crystals in their synovial fluid.
Other data
| Title | Synovial Fluid Analysis in patients with Primary Osteoarthritis of the Knee Joint | Other Titles | تحليل السائل المفصلى لمرضى خشونة الركبة الأولى | Authors | HALA SAMIR AHMED EL BADAWY | Keywords | .ostearthritis, synovial fluid, crystals, CPPD, polarized microscope, Alizarin stain | Issue Date | 2000 |
Recommend this item
Similar Items from Core Recommender Database
Items in Ain Shams Scholar are protected by copyright, with all rights reserved, unless otherwise indicated.