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Rationale:
- Not all septic joints have such high synovial fluid leukocyte counts, and some inflammatory synovial fluids have leukocyte
counts >75000 cells/µL. If the leukocyte count is high, suspect septic arthritis, even in the presence of monosodium urate
crystals. Most episodes of joint sepsis occur in joints that are already abnormal, and joint sepsis in those with crystal-induced
arthritis may “mine” the crystals from the synovium and articular surfaces, making them available for observation.
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Evidence:
- These values were derived from analyses of synovial fluid from a large sample of patients with inflammatory (including infection)
and noninflammatory conditions (28).
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Comments:
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Grace P. Teal, MD (deceased) has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
Howard A. Fuchs, MD, is a consultant for TAP Pharmaceuticals.
Darren B. Taichman, MD, PhD, Editor, PIER, has received grant support from Actelion Pharmaceuticals Ltd , and honoraria for
continuing medical education grand rounds and lectures given.
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The information included herein should never be used as a substitute
for clinical judgment and does not represent an official position of
ACP. Because all PIER modules are updated regularly, printed web pages
or PDFs may rapidly become obsolete. Therefore, PIER users should
compare the date of the last update on the website with any printout
to ensure that the information being referred to is the most current
available.
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PIER is copyrighted (c) 2010 by the American College of Physicians,
190 N. Independence Mall West, Philadelphia, PA 19106-1572, USA.
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Gout
> Diagnosis
