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Arthrocentesis - Joint Fluid Analysis Effusion Characteristics (Color, Clarity, WCC, PMN, Crystals, Bacteria) by Disease Process: OA,
Clarity, WCC, PMN, Crystals ... positively birefringent crystals ... negatively birefringent crystals ... TB arthritis, Septic ... Aspiration #Pseudogout #Septic
Arthrocentesis of synovial fluid - Interpretation - Normal - Noninflammatory - Inflammatory - Septic Viscosity of synovial
Inflammatory - Septic ... The presence of crystals ... does not rule out septic ... Aspiration #Pseudogout #Septic
Synovial Fluid Analysis: Findings (COLOR TRANSPARENCY VISCOSITY WBC COUNT (PER MM3) PMN CELL COUNT (%) GRAM STAIN CULTURE PCR TEST CRYSTALS) By Condition (Normal Noninflammatory Inflammatory:
CULTURE PCR TEST CRYSTALS ... Aspiration #Pseudogout #Septic
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 Joint Disorders - Differential Diagnosis Algorithm Monoarthritis • Septic • Crystalline - Gout
Monoarthritis • Septic ... Gout - Uric Acid Crystals ... Pyrophosphate Dihydrate Crystals ... Reiter’s syndrome) Aseptic
Approach to Joint Pain - Diagnostic Framework 1) Chronicity 2) Inflammatory vs Non-Inflammatory 3) Number of Joints Involved 1) Chronicity:
mycobacterial), RA, crystal ... (1 joint): • Septic ... culture, look for crystals ... • WBC >20k: Septic ... psoriatic arthritis Crystals
Septic Arthritis - Diagnosis and Management Summary Clinical Exam: hot, swollen, pain with passive AND active ROM
Septic Arthritis ... cell count, and crystal ... beneficial in septic ... nongonococcal septic ... unable to rule out septic
Differential Diagnosis of Acute Arthritis Crystal-induced arthritis: Calcium oxalate, gout, cholesterol, pseudogout, hydroxyapatite crystals Infectious arthritis: Bacteria, fungi,
Acute Arthritis Crystal-induced ... hydroxyapatite crystals ... Monoarticular #Septic
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 Approach to Gout Diagnosis: r/o septic arthritis! Needle-shaped, negative birefringent crystals Treatment: • Weight loss, diet, d/c culprit
Diagnosis: r/o septic ... negative birefringent crystals
Acromioclavicular (AC) Joint Septic Arthritis on POCUS IVDU with severe left shoulder pain. Can fully range
Acromioclavicular (AC) Joint Septic ... 64K WBC with no crystals ... AC joint septic ... sternoclavicular septic ... AC joint septic
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 Knee Effusions - Arthrocentesis Interpretation Inflammatory arthritis: • Color: Yellow-> Green • Clarity: Opaque • Viscosity: Low
Culture: Negative Septic ... number of RBC's Crystal ... Interpretation #diagnosis #septic
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