The utilization of synovial fluid analysis in the UK

• Published in: Rheumatology (Oxford, England) Vol. 40; no. 9; pp. 1060 - 1063
• Main Authors: Amer, H., Swan, A., Dieppe, P.
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.09.2001; Oxford Publishing Limited (England)
• Subjects: Assays; Biological and medical sciences; Crystallization; Crystals; Data Collection; Humans; Investigative techniques, diagnostic techniques (general aspects); Leukocyte Count; Medical sciences; Microbiology; Microscopy, Polarization; Musculoskeletal Diseases - diagnosis; Orthopedics - methods; Osteoarticular system. Muscles; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Polarized light microscopy; Rheumatology - methods; Surveys and Questionnaires; Synovial fluid; Synovial Fluid - cytology; Synovial Fluid - microbiology; United Kingdom; United Kingdom; Europe; Human; Synovial fluid; Biochemical analysis; Microbiological investigation; Indication; Acute; Arthritis; Diagnosis; Technique; Content analysis
• ISSN: 1462-0324; 1462-0332
• DOI: 10.1093/rheumatology/40.9.1060

Objective. To ascertain what use is being made of synovial fluid analysis in the UK, who is carrying out polarized light microscopy (PLM), and what confidence clinicians have in the results. Subjects and methods. A postal survey was developed, piloted, adjusted and then posted to 535 people, 90% of whom were senior rheumatologists and 10% orthopaedic surgeons, whose names had been obtained from professional lists. Results. Three hundred and eleven replies (59%) were obtained after 1 month. Analysis of the replies showed that only microbiological tests and PLM are used regularly, that these are used mainly for the diagnosis of acute arthritis, and that the majority of respondents would like data from these assays to be available within 24 h. The majority of the respondents (95%) had access to PLM and 80% said that clinicians should be able to use it. However, PLM is currently being undertaken by a variety of people: non‐specialist technicians (34% of respondents), specialist technicians (35%) and clinicians (31%). Respondents were confident in microbiological assays but not in cell counts or PLM, unless they were undertaking it themselves. Conclusions. There is an urgent need for guidelines, standardization and education about the use of synovial fluid assays in the UK.