joint fluid Flashcards
(39 cards)
role of synovial fluid
- Lubricate joints
- Shock absorption
- Nutrient absorption + waste removal
- Barrier against cell entry/fluid exit
ddx for increased soft tissue opacity in the joint space
degen, inflam, infectious, traumatic, neoplasia
necessary equipment for arthrocentesis
- 21G needle, 40mm
- 5ml syringe (dogs)/2ml (cats)
- EDTA blood tube
- Blood culture tube
- Slides
technique of carpus arthrocentesis
- Flexed 90degrees
- Depression at radiocarpal jt
- Needle medial to cephalic vein, btwn CDE (lateral) + ECR (medial)
technique of talocrural joint arthrocentesis
- No flexion
- Needle medial to lateral malleolus at dorsomedial aspect of joint
- Direct needle plantar + medial
technique of stifle jt arthrocentesis
- Slight flexion + external rotation
- Needle lateral to patella lig, midway btwn patella + tibial tuberosity
- Direct needle 45degrees to skin + parallel to patella tendon + lateral to patella
normal gross appearance of joint fluid
- Volume: <0.5ml (distal joints)
- Viscosity: strand test - 2.5cm stretch
- Colour: colourless
- Turbidity: clear
gross appearance of infectious OR inflammatory joint fluid
- Volume: increased/normal
- Viscosity: reduces
- Colour: yellow, serosanguinous
- Turbidity: increased
preparation of joint fluid samples
- Slides for cytology - air dry + diff quik
- EDTA tube 0.1ml
- Blood culture tube 0.5ml
- aerobic media = blood
- *anaerobic media = transport
info gained from cytology
bacteria in 50% of septic arthritis cases
RBCs
neuts
normal TP of synovial fluid
<2.5g/dL
cell count characteristics of infectious/inflammatory synovial fluid
neut heavy
percentage of false negatives w/ joint culture
20-50% of cases thus neg. culture is not definitive
pathogens assoc. w/ septic arthritis in a dog
Strep. intermedius, beta-haemolytic strep
Staph. aureus
pathogens assoc. w/ septic arthritis in a cat
Bacteroides (fights)
Pasteurella multocida
Tx of septic arthritis
initial IV ABs, + ongoing PO 1month
ie. amoxiclav
when is sx intervention indicated in septic arthritis
- Gross contamination (FB/implant)
2. No response to medical management
resolution of septic arthritis is confirmed by….
repeat synovial analysis consistent w/ OA fluid
<3% neuts
prognosis of septic arthritis
resolves in 95% of cases
note: ongoing OA management indicated
synovial structures in the distal forelimb of a horse
- Coffin jt + navicular bursa
- Pastern jt
- Fetlock jt
+ assoc. DFT sheath
synovial structures in the carpus of a horse
- Carpometacarpal jt + carpal sheath
- Middle carpal jt + CDE + LDE tendon sheath
- Radiocarpal + ECR tendon sheath
synovial structures in the shoulder of a horse
bicipital bursa + glenohumeral jt
signalment of neonatal synovial sepsis in foals
<30d, failure of passive transfer –> haematogenous spread from other source
ie. pneumonia, umbilical infection, gastroenteritis
organisms commonly involved in foal synovial sepsis
Enterobacteriaceae
Salmonella
Satphylococcus