A synovial fluid has a high white cell count and large ...

[nenivikky]

A synovial fluid has a high white cell count and large intracellular needlelike crystals that are yellow when the crystals are parallel to the y-axis of a red compensator. What is the likely diagnosis?
 
  a. Pseudo-gout
  b. Gout
  c. Lupus erythematosus
  d. Bacterial infection

Question 2

How must synovial fluids be handled differently than other fluids?
 
  a. Perform a Gram stain if bacteria are seen.
  b. Dilute the fluid if the cell counts are high.
  c. Add hyaluronidase to overcome the viscous nature of fluid.
  d. Carefully search the whole cytospin preparation for malignant cells.

[katieost]

Answer to Question 1

ANS: B
These are monosodium urate crystals and are seen in gout.

Answer to Question 2

ANS: C
Synovial fluid contains hyaluronic acid, making it very viscous. Adding a small amount of hyaluronidase powder to the fluid will cause it to liquefy. Cell counts and/or cytocentrifuge slides can then be made.