A 51 year old man presents with swelling in both knees. The following morning, an arthrocentesis...
A 51 year old man presents with swelling in both knees. The following morning, an arthrocentesis is performed and blood is collected for chemistry testing. Results are as follows:
•Synovial Fluid results:
Color – Yellow
Clarity – Cloudy
WBC count – 43,000
Pmns – 63%
Monos – 24%
Lymphs – 13%
Crystals – many intracellular, needle-shaped crystals, negative birefringence
•Blood chemistry results:
Fasting glucose – 85 mg/dl
Uric acid – 12.7 mg/dl
•gram stain: no organisms seen, many WBCs seen
Questions (please answer all!)
1. identify any abnormal results.
2. Of the 4 classifications of joint disorders, what would this fluid be classified as? What results led you to this classification? BE SPECIFIC!
3. What is the most likely identity of the crystals?
4. What is the most probable diagnosis?
5. If no crystals were observed, would the diagnosis change? Why or why not?