Brannan Scott R, Jerrard David A
University of Maryland, Baltimore, MD, USA.
J Emerg Med. 2006 Apr;30(3):331-9. doi: 10.1016/j.jemermed.2005.05.029.
AsA prompt and accurate diagnosis of a painful, swollen joint is imperative, primarily in the case of a septic joint, as delayed therapy may result in progression of disease or permanent loss of function. Procurement and analysis of synovial fluid (SF) are paramount in helping the clinician to determine a patient's clinical condition and further course of treatment. Measurement of white blood cell (WBC) counts, crystal analysis by polarized microscopy, and microbiologic studies including Gram stain and culture are the SF parameters that are collectively most important in the ultimate determination by a clinician of the presence or absence of an infectious or inflammatory joint. It is important for the clinician to understand and recognize the limitations of various SF parameters to minimize under-treating patients with potentially serious joint pathology.
对于疼痛、肿胀的关节，迅速而准确的诊断至关重要，尤其是在脓毒性关节炎的情况下，因为延迟治疗可能导致疾病进展或功能永久性丧失。获取和分析滑液（SF）对于帮助临床医生确定患者的临床状况和进一步的治疗方案至关重要。白细胞（WBC）计数的测定、偏振显微镜下的晶体分析以及包括革兰氏染色和培养在内的微生物学研究是滑液参数，这些参数对于临床医生最终确定是否存在感染性或炎症性关节最为重要。临床医生了解和认识各种滑液参数的局限性很重要，以尽量减少对患有潜在严重关节病变的患者治疗不足的情况。
