• DVM360_Conference_Charlotte,NC_banner
  • ACVCACVC
  • DVM 360
  • Fetch DVM 360Fetch DVM 360
DVM 360
dvm360 | Veterinary News, Veterinarian Insights, Medicine, Pet Care
dvm360 | Veterinary News, Veterinarian Insights, Medicine, Pet Care
By Role
AssociatesOwnersPractice ManagerStudentsTechnicians
Subscriptions
dvm360 Newsletterdvm360 Magazine
News
All News
Association
Breaking News
Education
Equine
FDA
Law & Ethics
Market Trends
Medical
Politics
Products
Recalls
Regulatory
Media
dvm360 LIVE!™
Expert Interviews
The Vet Blast Podcast
Medical World News
Pet Connections
The Dilemma Live
Vet Perspectives™
Weekly Newscast
dvm360 Insights™
Publications
All Publications
dvm360
Firstline
Supplements
Vetted
Clinical
All Clinical
Anesthesia
Animal Welfare
Behavior
Cardiology
CBD in Pets
Dentistry
Dermatology
Diabetes
Emergency & Critical Care
Endocrinology
Equine Medicine
Exotic Animal Medicine
Feline Medicine
Gastroenterology
Imaging
Infectious Diseases
Integrative Medicine
Nutrition
Oncology
Ophthalmology
Orthopedics
Pain Management
Parasitology
Surgery
Toxicology
Urology & Nephrology
Virtual Care
Business
All Business
Business & Personal Finance
Hospital Design
Personnel Management
Practice Finances
Practice Operations
Wellbeing & Lifestyle
Continuing Education
Conferences
Conference Listing
Conference Proceedings
Upcoming dvm360 Conferences
Resources
CBD in Pets
CE Requirements by State
Contests
Partners
Spotlight Series
Team Meeting in a Box
Toolkit
Top Recommended Veterinary Products
Vet to Vet
Veterinary Heroes
  • Contact Us
  • Fetch DVM360 Conference
  • Terms and Conditions
  • Privacy
  • Do Not Sell My Information
  • About Us

© 2023 MJH Life Sciences and dvm360 | Veterinary News, Veterinarian Insights, Medicine, Pet Care. All rights reserved.

Advertisement
By Role
  • Associates
  • Owners
  • Practice Manager
  • Students
  • Technicians
Subscriptions
  • dvm360 Newsletter
  • dvm360 Magazine
  • Contact Us
  • Fetch DVM360 Conference
  • Terms and Conditions
  • Privacy
  • Do Not Sell My Information
  • About Us
  • MJHLS Brand Logo

© 2023 MJH Life Sciences™ and dvm360 | Veterinary News, Veterinarian Insights, Medicine, Pet Care. All rights reserved.

Arthrocentensis: practical and valuable (Proceedings)

August 1, 2011
R.D. Montgomery, DVM, MS, DACVS

Synovial membrane lines all diarthrodial joints. Synoviocytes are macrophage like cells which phagocytize foreign materials and produce synovial fluid which contains the two lubricants hyaluronic acid and polysulfated glycosaminoglycans. The normal synovial membrane is a poor filter, allowing all components of blood into the joint fluid except cells, platelets, and large molecules such as fibrinogen.

Synovial membrane lines all diarthrodial joints. Synoviocytes are macrophage like cells which phagocytize foreign materials and produce synovial fluid which contains the two lubricants hyaluronic acid and polysulfated glycosaminoglycans. The normal synovial membrane is a poor filter, allowing all components of blood into the joint fluid except cells, platelets, and large molecules such as fibrinogen.

Normal synovial fluid is ≤ 1/2 milliliter (even in large joints of large dogs), clear, transparent, and has viscosity enough to cause the fluid to stretch 9 inches or more when dropped from a needle before breaking.

Arthritis includes degenerative joint disease (DJD) aka osteoarthritis (OA); immune mediated arthritis (e.g. rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE)); and infectious arthritis.

For all of these types of arthritis, the first response to the insulting etiology is inflammation of the synovial membrane. The result in increased volume of synovial fluid, coloration (yellow color with DJD, yellow or other colors with infectious or immune mediated arthritis), turbidity, and loss of viscosity. In addition, larger than normal molecules, including fibrinogen, enter the joint fluid resulting in the joint fluid clotting after collection unless placed in an EDTA or other anti-coagulant coated blood collection tube.

Advertisement

Analysis of joint fluid is very sensitive in identifying that a joint is normal or is abnormal. Joint fluid is less helpful in identifying the specific pathology present. However, identifying a joint as unquestionably normal or unquestionably abnormal is very helpful to the diagnostic process via ruling in or ruling out a joint as the (or a) anatomic location of pathology. Recognize that joint fluid is specific to the intra-articular joint, not surrounding joint anatomy.

     • Normal joint fluid: volume ≤ 1/2 milliliter, clear or slightly yellow, transparent, stretch of > 9 inches.

     • DJD: volume > 1 milliliter, distinct yellow, transparent, stretch of 6 - 9 inches.

     • Immune or infectious: > 1 ml, various colors, loosing or not transparent, stretch of ≤ 2 inches.

     • Note: streaks of blood are iatrogenic, well mixed blood was present before the needle entered.

Gross properties of joint fluid are typically all that is needed; although clinical pathology and cytologic analysis of joint fluid can be helpful in a few circumstances.

Cytology of Joint Fluid may be helpful in identifying immune mediated vs infectious arthritis.

Difficulty comes in separating immune mediated arthritis from septic arthritis. If WBC count is higher than 20,000, then is not DJD. If see toxic neutrophils and/or phagocytized bacteria, then is infectious (bacteria outside of PMN's may be contamination of cytologic stain(s). Bacterial culture of joint fluid or joint membrane if positive is reliable, but if negative is meaningless since there is a 50% false negative culture rate with joint cultures. If in doubt, treat with antibiotics and if no response to treatment in 2-3 days, then can reasonably treat as immune disease with corticosteriods (corticosteroid and or delay of antibiotics is devastating to an infected joint). Collection of synovial fluid is demonstrated on video.

Related Content:

SurgeryOrthopedics
FHO vs total hip replacement: separating fact from fiction
FHO vs total hip replacement: separating fact from fiction
What to consider in difficult dental extractions
What to consider in difficult dental extractions
dvm360® is seeking nominations for the 2023 Veterinary Heroes Awards
dvm360® is seeking nominations for the 2023 Veterinary Heroes Awards

Advertisement

Latest News

Comparing treatments for restoring the skin barrier in atopic dogs

Increasing efficiency and productivity in uncertain times

AAVMC awards almost $100,000 in diversity scholarships

News wrap-up: This week’s headlines, plus Maryland Zoo welcomes baby addra gazelle

View More Latest News
Advertisement