![]() Chemistry determinations should be done promptly or else the fluid should be centrifuged and the supernatant refrigerated. Cell counts and crystal examination can be performed on fluid that is 1 or 2 days old, if refrigerated, though there will be some cell loss. Any remaining fluid may be placed in an appropriate tube and sent for complete blood count, differential, and those tests deemed most useful. Normal fluid will form a string 5 to 8 cm in length before breaking. Viscosity can be checked by observing the length of the string formed as the syringe is pulled away from the slide. The edges may be sealed with clear nail polish if the slide will not be examined immediately. One drop should be spread on one of the glass slides for gram stain, and another drop should be placed on the other slide for crystal examination and covered with a cover slip. If a smaller amount of fluid is obtained, the first few drops should go into the culture tube. The following materials should be available before an aspiration is performed: The physician should develop some facility in performing and interpreting a microscopic examination, in the event that the laboratory is not always immediately accessible, or if the laboratory report is questioned. Consequently, it is prudent to specify the desired tests rather than simply request a "routine" analysis. Recent studies have shown a considerable variation in what various laboratories consider to be routine and in the accuracy of their reports. The mucin clot test can be done, but adds little to the viscosity, white blood cell count, and differential as a measure of inflammation. Special cultures and chemistries may be indicated in unusual circumstances. Glucose and protein are ordered only if there is sufficient fluid. As a minimum, a white blood cell count with differential, a microscopic examination under polarized light for crystals, a gram stain, and bacteriologic cultures should be done. ![]() Therefore, it is the responsibility of the examining physician to record a gross description of the fluid (volume, color, clarity, and viscosity). If you think you may have a medical emergency, call your physician or 911 immediately.There is no routine for joint fluid analysis. By using this Site you agree to the following Terms and Conditions. We offer this Site AS IS and without any warranties. Never disregard the medical advice of your physician or health professional, or delay in seeking such advice, because of something you read on this Site. We disclaim all responsibility for the professional qualifications and licensing of, and services provided by, any physician or other health providers posting on or otherwise referred to on this Site and/or any Third Party Site. ![]() ![]() MedHelp is not a medical or healthcare provider and your use of this Site does not create a doctor / patient relationship. It is not intended to be and should not be interpreted as medical advice or a diagnosis of any health or fitness problem, condition or disease or a recommendation for a specific test, doctor, care provider, procedure, treatment plan, product, or course of action. The Content on this Site is presented in a summary fashion, and is intended to be used for educational and entertainment purposes only.
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