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Synovial fluid in gout

Authoring team

Monosodium urate crystal identification remains the gold standard for diagnosing gout. Gout flares are characterized by the presence of MSU crystals in synovial fluid from affected joints or bursae, visualized using compensated polarized light microscopy. The crystals are often intracellular, indicating active phagocytosis. Typical synovial fluid characteristics with gout include:

  • appearance: clear
  • viscosity: LOW
  • WCC: 10,000 x 10^6/L Neutrophils
  • crystals: needle shaped, negatively birefringent
  • culture: sterile

Reference

  1. Sivera F, Andrés M, Quilis N. Gout: Diagnosis and treatment. Med Clin (Barc). 2017 Mar 22;148(6):271-276

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