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Synovial Fluid Analysis

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What is a synovial fluid analysis?

Synovial fluid, also known as joint fluid, is a thick liquid located between your joints. The fluid cushions the ends of bones and reduces friction when you move your joints. Synovial fluid analysis is a group of tests that checks for disorders that affect the joints. The tests usually include the following:

  • An exam of physical qualities of the fluid, such as its color and thickness
  • Chemical tests to check for changes in the fluid’s chemicals
  • Microscopic analysis to look for crystals, bacteria, and other substances

Other names: joint fluid analysis

What is it used for?

Synovial fluid analysis is used to help diagnose the cause of joint pain and inflammation. Inflammation is the body’s response to injury or infection. It can cause pain, swelling, redness, and loss of function in the affected area. Causes of joint problems include:

  • Osteoarthritis, the most common form of arthritis. It is a chronic, progressive disease that causes joint cartilage to break down. It can be painful and lead to loss of mobility and function.
  • Gout, a type of arthritis that causes inflammation in one or more joints, usually in the big toe
  • Rheumatoid arthritis, a condition in which the body’s immune system attacks healthy cells in your joints
  • Joint effusion, a condition that happens when too much fluid builds up around a joint. It often affects the knee. When it affects the knee, it may be referred to as knee effusion or fluid on the knee.
  • Infection in a joint
  • Bleeding disorder, such as haemophilia. Haemophilia is an inherited disorder that can cause excessive bleeding. Sometimes the excess blood ends up in the synovial fluid.
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Why do I need a synovial fluid analysis?

You may need this test if you have symptoms of a joint disorder. These include:

  • Joint pain
  • Joint swelling
  • Redness at a joint
  • Joint that feels warm to the touch

What happens during a synovial fluid analysis?

Your synovial fluid will be collected in a procedure called arthrocentesis, also known as joint aspiration. During the procedure:

  • A health care provider will clean the skin on and around the affected joint.
  • The provider will inject an anaesthetic and/or apply a numbing cream to the skin, so you won’t feel any pain during the procedure. If your child is getting the procedure, he or she may also be given a sedative. Sedatives are medicines that have a calming effect and help reduce anxiety.
  • Once the needle is in place, your provider will withdraw a sample of synovial fluid and collect it in the syringe of the needle.
  • Your provider will put a small bandage on the spot where the needle was inserted.

The procedure usually takes less than two minutes.

Will I need to do anything to prepare for the test?

You may need to fast (not eat or drink) for several hours before the test. Your health care provider will let you know if you need to fast and if there are any special instructions to follow.

Are there any risks to the test?

Your joint may be sore for a couple of days after the procedure. Serious complications, such as infection and bleeding may happen, but are uncommon.

What do the results mean?

If your results show your synovial fluid was not normal, it may mean one of the following conditions:

  • A type of arthritis, such as osteoarthritis, rheumatoid arthritis, or gout
  • Bleeding disorder
  • Bacterial infection
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Your specific results will depend on what abnormalities were found. If you have questions about your results, talk to your health care provider.

Is there anything else I need to know about a synovial fluid analysis?

Arthrocentesis, the procedure used to do a synovial fluid analysis, may also be done to remove excess fluid from a joint. Normally, there is only a small amount of synovial fluid between the joints. If you have a joint problem, extra fluid can build up, causing pain, stiffness, and inflammation. This procedure can help relieve pain and other symptoms.

References

  1. Arthritis-health [Internet]. Deerfield (IL): Veritas Health, LLC; c1999–2020. What Causes a Swollen Knee?; [updated 2016 Apr 13; cited 2020 Feb 3]; [about 3 screens]. Available from: https://www.arthritis-health.com/types/general/what-causes-swollen-knee-water-knee
  2. Kids Health from Nemours [Internet]. Jacksonville (FL): The Nemours Foundation; c1995–2020. Joint Aspiration (Arthrocentesis); [cited 2020 Feb 3]; [about 3 screens]. Available from: https://kidshealth.org/en/parents/arthrocentesis.html
  3. Lab Tests Online [Internet]. Washington D.C.: American Association for Clinical Chemistry; c2001–2020. Osteoarthritis; [updated 2019 Oct 30; cited 2020 Feb 3]; [about 3 screens]. Available from: https://labtestsonline.org/conditions/osteoarthritis
  4. Lab Tests Online [Internet]. Washington D.C.: American Association for Clinical Chemistry; c2001–2020. Synovial Fluid Analysis; [updated 2020 Jan 14; cited 2020 Feb 3]; [about 3 screens]. Available from: https://labtestsonline.org/tests/synovial-fluid-analysis
  5. Radiopaedia [internet]. Radiopaedia.org; c2005-2020. Joint effusion; [cited 2020 Feb 25]; [about 3 screens]. Available from: https://radiopaedia.org/articles/joint-effusion?lang=us
  6. UF Health: University of Florida Health [Internet]. Gainesville (FL): University of Florida Health; c2020. Gout: Overview; [updated 2020 Feb 3; cited 2020 Feb 3]; [about 2 screens]. Available from: https://ufhealth.org/gout
  7. UF Health: University of Florida Health [Internet]. Gainesville (FL): University of Florida Health; c2020. Synovial fluid analysis: Overview; [updated 2020 Feb 3; cited 2020 Feb 3]; [about 2 screens]. Available from: https://ufhealth.org/synovial-fluid-analysis
  8. University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; c2020. Health Encyclopedia: Hemophilia in Children; [cited 2020 Feb 3]; [about 2 screens]. Available from: https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=90&contentid=P02313
  9. University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; c2020. Health Encyclopedia: Uric Acid (Synovial Fluid); [cited 2020 Feb 3]; [about 2 screens]. Available from: https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=uric_acid_synovial_fluid
  10. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2020. Joint Fluid Analysis: How It Is Done; [updated 2019 Apr 1; cited 2020 Feb 3]; [about 5 screens]. Available from: https://www.uwhealth.org/health/topic/medicaltest/joint-fluid-analysis/hw231503.html#hw231523
  11. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2020. Joint Fluid Analysis: Results; [updated 2019 Apr 1; cited 2020 Feb 3]; [about 8 screens]. Available from: https://www.uwhealth.org/health/topic/medicaltest/joint-fluid-analysis/hw231503.html#hw231536
  12. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2020. Joint Fluid Analysis: Risks; [updated 2019 Apr 1; cited 2020 Feb 3]; [about 7 screens]. Available from: https://www.uwhealth.org/health/topic/medicaltest/joint-fluid-analysis/hw231503.html#hw231534
  13. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2020. Joint Fluid Analysis: Test Overview; [updated 2019 Apr 1; cited 2020 Feb 3]; [about 2 screens]. Available from: https://www.uwhealth.org/health/topic/medicaltest/joint-fluid-analysis/hw231503.html
  14. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2020. Joint Fluid Analysis: Why It Is Done; [updated 2019 Apr 1; cited 2020 Feb 3]; [about 3 screens]. Available from: https://www.uwhealth.org/health/topic/medicaltest/joint-fluid-analysis/hw231503.html#hw231508
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