Dotsenko T G, Shlikova G I, Teplyakova O V
Klin Lab Diagn. 2016 Aug;61(8):478-84.
The review presents modern data concerning characteristics of drawing of synovial fluid and also informativeness of its particular indices for resolving main clinical differential diagnostic task namely - selection group of septic and micro-crystal arthritis. It is demonstrated that minimal generally available span of analysis of synovial fluid is to include: finding number of leukocytes (threshold level for diagnostic of septic arthritis is 50 000 - 100 000 kl/mkl) and percentage of ploymorpho-nuclear cells (threshold level is 90%); analysis of content of crystals, Gram's stain and culture analysis of synovial fluid using light microscopy; and all this with mandatory registration of clinical data. The common evaluation of content of glucose and protein in synovialfluid is not enough informative. The detection of concentration of procalcitonin and lactate in synovial fluid is perspective for establishing septic genesis of arthritis. The sensitivity and specificity of light microscopy are quite high. Because of it absence of polarized microscope is no obstacle for implementation of crystallographic analysis of synovial fluid.
这篇综述介绍了有关滑膜液抽取特征的现代数据，以及其特定指标对于解决主要临床鉴别诊断任务（即区分脓毒性关节炎和微晶性关节炎）的信息价值。结果表明，滑膜液分析的最低常规范围应包括：白细胞计数（脓毒性关节炎的诊断阈值为50000 - 100000个/微升）和多形核细胞百分比（阈值为90%）；利用光学显微镜对滑膜液进行晶体成分分析、革兰氏染色和培养分析；所有这些都必须记录临床数据。对滑膜液中葡萄糖和蛋白质含量的常规评估信息不足。检测滑膜液中降钙素原和乳酸的浓度对于确定关节炎的脓毒性病因具有前景。光学显微镜的敏感性和特异性相当高。因此，没有偏振显微镜并不妨碍进行滑膜液的晶体分析。
