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Case Report
- Cytology of Synovial Fluid in Gouty Arthritis: Two Cases Report.
- Ji Young Kim, Yi Kyeong Chun, Hoi Sook Jang, Bok Man Kim, Hy Sook Kim, Jae Yong An, Sung Ran Hong
- Korean J Pathol. 2009;43(1):92-97.
- DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.1.92
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Abstract
PDF - Synovial fluid (SF) aspiration cytology is a useful diagnostic tool. For patients with gouty arthritis, the diagnosis is confirmed by the presence of monosodium uric acid (MSU) crystals in the SF, and these crystals are long, pointed ended and needle-shaped and they show strongly negative birefringence. Sometimes, it is difficult to diagnosis between gouty arthritis and other type of inflammatory arthritis. We experienced two unusual cases of gouty arthritis that we performed SF analysis for. The first patient was a 35 year old male who presented with relatively typical clinical symptoms with hyperuricemia, but the SF showed acute inflammatory cells without crystals on light microscopy. Only a few suspected crystals of MSU were identified on polarizing microscopy. The second patient was a 45 year old male who presented with atypical symptoms and pain and swelling of the left ankle and knee joint for 3 weeks. The uric acid level in the serum and urine was increased, but not over the normal limit. However, on light and polarizing microscopy, there were numerous MSU crystals in the SF. Conclusively, in some cases of gouty arthritis, the crystals are not identified on light microscopy or the uric acid level is not dramatically increased. So, the polarizing microscopy, the clinical information and the laboratory findings are all included in the work-up when evaluating the SF cytology of arthritis patients.
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Citations
Citations to this article as recorded by
- Diagnostic indications of knee joint fluid – current state ofknowledge
Damian Turzański
Diagnostyka Laboratoryjna.2023; 59(4): 1. CrossRef
- Diagnostic indications of knee joint fluid – current state ofknowledge
Original Article
- Ragocytes in Synovial Fluid.
- Sang Yoon Kim, Je Geun Chi
- Korean J Pathol. 1987;21(1):54-56.
- 3,257 View
- 219 Download
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Abstract
PDF
- Exfoliative cytology of synovial fluid is less stressed in medical practice, but it can be a very useful tool for the differential diagnosis of various joint diseases. This report describes a case of juvenile rheumatoid arthritls in a 7 year old girl, who showed characteristic ragocytes in joint fluid. Synovial biopsy specimen confirmed the diagnosis of rheumatoid arthritis.
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