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Test Code CC SF Cell Count Synovial Fluid

Additional Codes

Cerner

NextGen

Cell Count Synovial Fluid

Cell Count Synovial Fluid

Alternate Name(s)

Cell Count Bursa Fluid

Methodology

Two methods are available for cell counts: An automated CBC instrument (XN) utilizing flow cytometry, and a manual Hemacytometer. The automated method is preferred, reserving the manual method for low counts that fall below the automated linearity limits. Manual differentials are performed on slides prepared by cytocentrifuge and stained with Modified Wrights Giemsa stain.

Patient Preparation

None

Collection Instructions

  • Specimen source must be indicated on label and requisition(s).
  • The tube submitted for cell counts must not be a previously centrifuged specimen.
  • Do not use mechanical rockers to mix specimens.

Specimen Requirements

Preferred Volume

2 mL or more

Minimum Volume

Due to the nature of BF specimens, no volume is rejected, but if specimen volume is inadequate, not all testing may be completed. The provider and/or pathologist will be contacted to discuss test priority if specimen volume is inadequate.

  • Sysmex open mode: 300 µL
  • Sysmex closed mode: 1 mL
  • Hemacytometer Manual: 500 µL

Container

K2EDTA lavender

Stability
  • 1 hour at room temperature
  • 2 hours at 2-8⁰C.        

Rejection Criteria
  • Clotted Specimens:
    • The provider will be notified.
    • If a cell count and differential are still required, a comment under specimen result "Specimen clotted; results may be inaccurate.”  The requesting provider’s name will also be added in the comment documented with the result.

Result Reporting and Reference Values

Reference Range

Parameter

Units

Sex

Age

Reference Range

Synovial Fluid Color

Not Defined

Synovial Fluid Character

Not Defined

Synovial Fluid Volume

mL

All

0D-150Y

Not Defined

Synovial Fluid Source

Ankle Left

Ankle Right

Elbow Left

Elbow Right

Hip Left

Hip Right

Joint Fluid

Knee Left

Knee Right

Shoulder Left

Shoulder Right

Wrist Left

Wrist Right

Synovial Fluid WBC

/mm3

All

0D-150Y

0

--

150

Synovial Fluid RBC

/mm3

0D-150Y

Not Defined

Synovial Fluid PMN %

%

0D-150Y

0

--

25

Synovial Fluid Lymph %

0D-150Y

75

--

100

Synovial Fluid Mono %

0D-150Y

Not Defined

Synovial Fluid Other Cells %

0D-150Y

0

--

1

 

Critical Ranges

None

Reflex Testing

Pathology Fluid Cell Review will be reflexed if “Other” cells were identified in the differential.

Limitations

  • WBC interferences:  NRBCs, giant platelets, precipitated elevated proteins, fragmented cells, unlysed particles > 35 fL in size, crystals and other elements.
  • RBC interferences:  Include highly elevated WBC, high concentration of very large platelets, auto agglutination, etc.
  • Crystals in fluids may be counted in error by automated instruments.

Useful For

Exams on joint fluids are performed to help in the diagnosis of inflammatory and non-inflammatory conditions. Most body fluids exist in small quantities in healthy individuals and serve as lubricant to prevent friction between the organ and the sac that contains it. When disease processes occur, fluid accumulation can occur in quantities sufficient to aspirate for analysis.

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