Like all specialized areas of medicine, that of joint disease informative. The techniques, practical and interpretive, has become surrounded by a practical mystique and are highly reproducible and simple, allowing them to be applied in any laboratory. jargon specific to itself. The number of clinicians working Although we see this volume as being of value to all in the field is large but the number of pathologists small. interested in joint disease it is specifically aimed at It follows that the majority of pathologists are at somewhat laboratory staff wishing to offer a synovial fluid analytical of an immediate disadvantage when discussing and ana­ service. Like most cytology we believe much of the cell lysing articular problems with their rheumatological and and non-cell identification and quantitation can, and orthopaedic colleagues. should, be undertaken by trained technical staff. The book In the specific area of synovial fluid examination the is therefore aimed primarily at two groups: pathologists difficulties for the pathologist are compounded because who do not specialize in joint disease and technical staff to date there have been no basic texts that detail the who will be generating the data on which interpretation methods, findings and interpretation of the macroscopic will be based. It is therefore both a text book and a bench and microscopic characteristics of the fluid in the common reference manual. arthropathies. In this book we hope to go some way We do not believe our data or methodology represent towards rectifying this omission.

Inhalt

1 The nature of joints and joint diseases.- 2 The nature of synovial fluid.- 3 Techniques for the examination of synovial fluid - general remarks.- 4 Technical methods.- 5 Naked eye examination of synovial fluid.- 6 Total cell count and the 'wet prep' examination and interpretation 1. Cells.- 7 The 'wet prep' examination and interpretation 2. Endogenous crystals other than lipid.- 8 The 'wet prep' examination and interpretation 3. Other endogenous and exogenous particles.- 9 Cytocentrifuge preparations 1. Organisms.- 10 Cytocentrifuge preparations 2. Synovial fluid cells.- 11 Cytocentrifuge preparations 3. Granular cells.- 12 Cytocentrifuge preparations 4. Large mononuclear cells.- 13 Cytocentrifuge preparations 5. Other cells.- 14 Primary inflammatory arthropathies 1. General remarks.- 15 Primary inflammatory arthropathies 2. Rheumatoid arthritis.- 16 Primary inflammatory arthropathies 3. Seronegative spondylarthropathies.- 17 Primary inflammatory arthropathies 4. Other disorders.- 18 Non-inflammatory arthropathies 1. Osteoarthritis.- 19 Non-inflammatory arthropathies 2. Trauma.- 20 Non-inflammatory arthropathies 3. Other disorders.- 21 Infective arthritis.- 22 Crystal-induced disease.- 23 Juvenile arthritis.- 24 Other specific arthropathies.- 25 The role of synovial fluid microscopy in the diagnosis of joint disease.- 26 Flow diagram for differential diagnosis.