Joint fluid examination

The serosal cavity of the human body has pleural cavity, pericardial cavity, peritoneal cavity, joint cavity, scrotal sheath cavity and the like. Under normal conditions, there is only a small amount of liquid in the cavity, which acts as a slip. However, under pathological conditions, there may be a large amount of fluid in the cavity, called serosal effusion, such as pleural effusion, ascites, pericardial effusion, scrotal hydrocele, and joint cavity effusion. Due to the different causes of effusion, it can be divided into two types: leakage liquid and exudate. The various components and properties are obviously different. Check the amount, appearance, pH, relative density, protein, glucose and microscopy of various effusions. The significance lies in the difference in the nature of the effusion, whether it is leakage or exudate, and then find out the cause and conduct diagnosis and treatment. Basic Information Specialist classification: growth and development check classification: body fluid examination Applicable gender: whether men and women apply fasting: not fasting Tips: Before the exam: listen to the doctor and put your posture. Normal value There are 1 ~ 3ml in the joint cavity, colorless or light yellow transparent liquid, usually not easy to be extracted. Clinical significance Abnormal result (1) Increase in amount seen in non-inflammatory arthritis, inflammatory arthritis, and septic arthritis. (2) color Grass green is found in rheumatoid arthritis, bacterial infections, tuberculous arthritis, and immunodeficiency. Red is found in trauma, hemophilia, scurvy, tumors, hemangioma, pigmented villonodular synovitis, and fractures that penetrate the joint. If it is uneven red, it will be damaged when the joint is puncture. Yellowish brown is seen in old intra-articular bleeding. Milky white is found in tuberculous arthritis, rheumatoid arthritis, acute gouty arthritis, systemic lupus erythematosus, and the like. (3) Translucent opacity is seen in septic arthritis (such as bacterial infection, tuberculous arthritis, immune function defects), inflammatory arthritis (such as rheumatoid arthritis, psoriatic arthritis, viral arthritis, rheumatic fever) , gout, etc.). (4) Total protein 20.0～30.0g/L was slightly elevated, which was found in inflammatory arthritis and degenerative arthritis; 40.0～70.0g/L was significantly elevated, which was found in rheumatoid arthritis and gout. (5) Glucose < 2.20 mmol / L, suggesting inflammatory arthritis. (6) white blood cell count (200 ~ 2000) × 106 / L, found in non-inflammatory arthritis; (2000 ~ 75000) × 106 / L, found in inflammatory arthritis; > 10000 × 106 / L, found in septic arthritis . (7) Leukocyte differential count neutrophils >50%, found in inflammatory arthritis; neutrophils >75%, found in septic arthritis. Precautions Before the examination: Listen to the doctor and put your posture. Inspection process The joint cavity is puncture and pumped for inspection. Inspection process: 1. The patient is lying on the operating table and the two lower limbs are straight. 2. The puncture site is routinely disinfected by the skin. The physician wears sterile gloves, sterilizes the hole towel, and uses local anesthesia with 2% lidocaine. 3. Use the 7-9 needle, usually under the tibia, from the lateral side of the quadriceps tendon into the joint capsule; or under the humerus, puncture the joint capsule from the ligament of the tendon. 4. After the pumping is completed, if you need to inject the medicine, you should change the sterile syringe. 5. Cover the puncture site with sterile gauze after surgery, and then fix it with tape. Not suitable for the crowd Inappropriate people: People who need to be examined have sudden joint pain, no body weakness, fever, headache or various arthritis symptoms. Those without examination indications should not be tested. Adverse reactions and risks Infection: Pay attention to aseptic operation during puncture, pay attention to local cleaning after puncture, prevent water pollution and avoid infection. Bleeding: Puncture needle damage to local vascular tissue can cause bleeding.

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