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Synovial fluid, organisms on acid fast stain: the finding of acid fast organisms suggests the presence of tuberculous arthritis. The diagnosis is confirmed by a positive culture of synovium and/or synovial fluid. WHAT: Synovial fluid: a classification of joint fluid obtained by sterile arthrocentesis, according to its characteristics noted by certain laboratory examinations. WHY: Type I synovial fluid (non-inflammatory) often occurs in degenerative joint disease, trauma, osteochondritis dissecans, osteochondromatosis, neuropathic arthropathy, subsiding or early inflammation, hypertrophic osteoarthropathy, and pigmented villonodular synovitis. Type II synovial fluid (inflammatory) often occurs in rheumatoid arthritis, acute crystal-induced synovitis (gout and pseudogout), Reiter\'s syndrome, ankylosing spondylitis, psoriatic arthritis, arthritis accompanying ulcerative colitis and regional enteritis, rheumatic fever, systemic lupus erythematosus, and progressive systemic sclerosis (scleroderma). Type III synovial fluid (septic) often occurs in bacterial infections. HOW: Normal -- WBCs <200/cu mm, PMNs <25%, culture negative, glucose in mg/dl nearly equal to that of blood. Type I (Noninflammatory) -- WBCs 200-2,000/cu mm, PMNs <25%, culture negative, glucose in mg/dl nearly equal to blood. Type II (Inflammatory) -- WBCs 2,000-100,000/cu mm, PMNs >=50%, culture negative, glucose >25mg/dl and lower than blood. Type III (Septic) -- WBCs >100,000/cu mm, PMNs >=75%, culture often positive, glucose <25mg/dl and much lower than blood. REFS: \'Examination of Joint Fluid\', Primer on the Rheumatic Diseases, 7th ed. New York, N.Y.: The Arthritis Foundation, 1973. DN19234-1.
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