Which synovial fluid analysis findings suggest rheumatoid arthritis (RA)?

Updated: Aug 22, 2019
  • Author: Howard R Smith, MD; Chief Editor: Herbert S Diamond, MD  more...
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Answer

Analysis of synovial fluid includes Gram staining, cell count, culture, and assessment of overall appearance. In patients with RA, analysis typically reveals inflammation (white blood cell [WBC] count >2000/µL, generally in the range of 5000-50,000/µL). Usually, neutrophil predominance (60-80%) is observed in the synovial fluid (in contrast with mononuclear cell predominance in the synovium). Because of a transport defect, glucose levels of synovial fluids (as well as pleural and pericardial fluids) in patients with RA are often low compared with serum glucose levels.


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