An Analysis of Different Types of Arthritis with Joint Effusions among Kashmiri Population in a Tertiary Care Hospital.

Abstract

Introduction: Arthritis is the initial manifestation of many joint disorders. Synovial fluid analysis helps in this aspect. Objective: To analyse the gross, microscopic and biochemical variations in the synovial fluid in various causes of joint effusions and to assess the synovial fluid cytology with biochemical parameters in various types of arthritis to increase the accuracy of diagnosis. Materials and Methods: In the present cross sectional study. Gross examination was done to find total volume, clarity, viscosity of the synovial fluid and it was equally divided into two halves. One half of synovial fluid was send for biochemical analysis and the other half for microscopic examination. Results: Out of 477 synovial fluid samples analysed. Total leucocyte count was found to be highest in septic arthritis and lowest in osteoarthritis. Neutrophils were highest in septic arthritis (95%) and lowest in osteoarthritis (24%). Sugar level in synovial fluid was highest in osteoarthritis and gouty arthritis (70-90 mg/dL each) and lowest in septic arthritis. Proteins were highest in rheumatoid arthritis and traumatic arthritis (4.1-6.5 gm/dL and 4.2-6.4 gm/dL respectively) and lowest in osteoarthritis (1.2-2.4 gm/dL). Out of 290 positive cases in synovial C-reactive protein levels, the highest were found in rheumatoid arthritis (130), rheumatoid factor was found positive in 143 cases while it was negative in 127 cases of osteoarthritis. Conclusion: Biochemical analysis of synovial fluid for proteins and sugar contributes in diagnosis of different types of arthritis. RF in synovial fluid proves to be of value in diagnosis of monoarticular arthritis.