Synovial fluid analysis is also particularly important for definitively diagnosing gout or pseudogout. The most important reason to perform a synovial fluid analysis may be to evaluate for septic arthritis in a patient presenting with an acutely swollen joint that is painful and warm even in patients with a known arthritic disease. INDICATIONS - Arthrocentesis with synovial fluid analysis should be attempted in all patients who have a joint effusion or signs suggestive of inflammation within the joint, without a known cause. (See "Septic arthritis in adults" and "Prosthetic joint infection: Epidemiology, microbiology, clinical manifestations, and diagnosis" and "Prosthetic joint infection: Treatment" and "Disseminated gonococcal infection" and "Bone and joint tuberculosis".) Septic arthritis, prosthetic joint infections, gonococcal arthritis, and fungal and mycobacterial arthritis are discussed in detail separately. An overview of synovial fluid analysis in the native joint is discussed here. The white cell count, differential count, cultures, Gram stain, and crystal search using polarized light microscopy are the most useful studies. INTRODUCTION - Synovial fluid analysis is helpful for determining the underlying cause of arthritis, particularly for septic or crystal-induced arthritis.
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