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Quality assurance for synovial fluid examination for crystals: an
improved method
Department of Rheumatology, Royal Prince Alfred & Rachel Forster Hospitals, Sydney, Australia
Correspondence to: Dr N W McGill, Suite 315, RPA Medical Centre, 100 Carillon Ave, Newtown NSW 2042, Australia.
Accepted for publication 2
June 1997
OBJECTIVE
To determine the best method of
preparing synovial fluid specimens for use in quality assurance (QA)
surveys designed to assess accuracy of crystal identification.
METHODSA previously published method (A) was
compared with a new method (B) in the setting of a QA survey. Ten
Australian, one New Zealand, and one Hong Kong hospital laboratories
took part in the survey. Each laboratory examined six different
synovial fluid specimens prepared using method A (first round) and a
separate six specimens using method B (second round). In method A, a
drop of synovial fluid on a glass slide was surrounded by a rim of Ultramount, sealed with a coverslip, and distributed. The participating laboratory did not need to perform any processing of the specimen before examination. In method B, a capillary tip was filled with synovial fluid, heat sealed, and distributed. The fluid was expelled onto a glass slide in preparation for examination after arrival in the
participating laboratory.
RESULTSUsing method A 36 of 71 (51%) of the
specimens were rated as satisfactory, compared with 53 of 61 (87%) of
the specimens using method B (Fisher's exact test, p<0.001).
CONCLUSIONSAn improved method of preparation of
synovial fluid specimens for QA surveys is described. Using the new
method it is feasible to perform a synovial fluid QA survey covering a
large area (Australasia).
© 1997 by Annals of the Rheumatic Diseases
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