What is included in synovial fluid analysis following shoulder arthrocentesis?

Updated: Dec 10, 2019
  • Author: Stephen Kishner, MD, MHA; Chief Editor: Erik D Schraga, MD  more...
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Answer

The following may be included in analysis:

  • Gram stain and culture should be performed on all samples suspicious for infection.
  • Total Leukocyte count and differential support differentiation between noninflammatory and inflammatory joint conditions.
    • If macrophage predominance (>80%): consider "Milwaukee shoulder"
  • Polarized microscopy evaluates for the presence of pathological crystals.
  • If inflammation or infection is not present, normal synovial fluid glucose is within 20 mg% of serum value.
  • Inflammation increases normal synovial fluid protein, and the average is approximately 2 mg% (33% of the serum total protein).
  • Ordering the following tests is not recommended due to low clinical significance: lactate dehydrogenase, uric acid, pH, electrolytes, and immunological studies.

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