How should synovial fluid be collected during the workup for gout?

Updated: Jan 26, 2021
  • Author: Bruce M Rothschild, MD; Chief Editor: Herbert S Diamond, MD  more...
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Answer

Analysis of synovial fluid for crystals should ideally be done within 24-48 hours after collection. Synovial fluid specimens may be stored at room temperature without any preservative, but refrigeration (at 4°C/39°F) and ethylenediaminetetraacetic acid (EDTA) preservation is reasonable. A systematic literature review by Meyer et al found that monosodium urate (MSU) crystals were generally stable over time, independent of preservative and temperature, whereas calcium pyrophosphate (CPP) crystals deteriorated over time and were more stable if refrigerated. Re-examining an initially negative synovial fluid sample at 24 hours facilitated detection of additional cases. [101]


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