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Synovial fluid analysis

Joint fluid analysis; Joint fluid aspiration

Synovial fluid analysis is a group of tests that examine joint (synovial) fluid. The tests help diagnose and treat joint-related problems.

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Joint aspiration

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How the Test is Performed

A sample of synovial fluid is needed for this test. Synovial fluid is normally a thick, straw-colored liquid found in small amounts in joints.

After the skin around the joint is cleaned, the health care provider inserts a sterile needle through the skin and into the joint space. Fluid is then drawn through the needle into a sterile syringe.

The fluid sample is sent to the laboratory. The laboratory technician:

How to Prepare for the Test

Normally, no special preparation is needed. Tell your provider if you are taking a blood thinner, such as aspirin, warfarin (Coumadin), or clopidogrel (Plavix). These medicines can affect test results or your ability to take the test.

How the Test will Feel

Sometimes, the provider will first inject numbing medicine into the skin with a small needle, which will sting. A larger needle is then used to draw out the synovial fluid.

This test may also cause some discomfort if the tip of the needle touches bone. The procedure usually lasts less than 1 to 2 minutes. It may be longer if there is a large amount of fluid that needs to be removed.

Why the Test is Performed

The test can help diagnose the cause of pain, redness, or swelling in joints.

Sometimes, removing the fluid can also help relieve joint pain.

This test may be used when your doctor suspects:

What Abnormal Results Mean

Abnormal joint fluid may look cloudy or abnormally thick.

The following found in joint fluid can be a sign of a health problem:

Risks

Risks of this test include:

Considerations

Ice or cold packs may be applied to the joint for 24 to 36 hours after the test to reduce the swelling and joint pain. Depending on the exact problem, you can probably resume your normal activities after the procedure. Talk to your provider to determine what activity is most appropriate for you.

References

El-Gabalawy HS, Tanner S. Synovial fluid analyses, synovial biopsy, and synovial pathology. In: Firestein GS, Budd RC, Gabriel SE, McInnes IB, O'Dell JR, eds. Firestein & Kelley's Textbook of Rheumatology. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 56.

Pisetsky DS. Laboratory testing in the rheumatic diseases. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 242.

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Review Date: 6/13/2021  

Reviewed By: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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