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Test Code Crystal Syn Crystal Exam Synovial Fluid

Additional Codes

Cerner

NextGen

Crystal Exam Synovial Fluid

Crystal Exam Synovial Fluid

Methodology

Polarization Microscopy

Patient Preparation

None

Collection Instructions

Specimen source must be indicated on label and requisition(s).

Specimen Requirements

Preferred Volume

0.5 mL

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.

Container

Preferred: Plain Red Top Vacutainer tube

 Alternative: Sodium Heparin Vacutainer tube

Stability
  • 1 hour at room temperature
  • 4 hours at 2°C- 8°C
  • Over 4 hours with consultation with Pathologist

Rejection Criteria

None Listed

Result Reporting and Reference Values

Reference Range

Crystals are not normally present in Synovial Fluid.

Critical Ranges

None

Reflex Testing

None

Limitations

  • EDTA is not a recommended sample type but may be used if a Pathologist approves.
  • Oxalate or Lithium Heparin should not be used as anticoagulant since each may be associated with crystal formation.
  • Lithium heparin crystals can mimic CPPD crystals in appearance.
  • Sodium heparin may be used as an anticoagulant, if necessary, for crystal ID.

Useful For

The presence of crystals in synovial fluid is used for the diagnosis of arthritis and gout.  Crystals found in synovial fluid include monosodium urate (MSU) (gout), calcium pyrophosphate dehydrate (CPPD) (pseudogout), cholesterol, steroid and apatite.  Crystals may be intracellular or extracellular or both. The presence of monosodium urate (MSU) crystal is usually diagnostic of gout.