Extended report
The value of synovial fluid analysis in the assessment of knee
joint destruction in arthritis in a three year follow up study
S Åmana, J Ristelib, R Luukkainend, L Ristelib, M Kauppia e, P Nieminenc, M Hakalaa
a Division of
Rheumatology, Department of Internal Medicine, b Department of Clinical
Chemistry, c Medical Informatics Group, d University
of Oulu, Oulu, Finland Department of
Rheumatology, Satalinna Hospital, Harjavalta, Finland, e Rheumatism Foundation Hospital,
Heinola, Finland
Correspondence to: Dr S Åman, Department of Internal Medicine, University of Oulu, FIN-90220 Oulu, Finland.
Accepted for publication 19 May 1999
OBJECTIVES
To assess
the predictive significance of synovial fluid (SF) analysis for
progressive radiological knee joint destruction in arthritis.
METHODSAltogether 55 patients with arthritis and knee joint effusion were included in the
study. The diagnosis was rheumatoid arthritis (RA) for 44 of them,
chronic seronegative spondylarthropathy for seven and juvenile
rheumatoid arthritis for four. The mean age of the patients was 51.8 (SD 14.9, range 19-82) years, and the mean duration of disease 10.9 (SD 9.2, range 0.5-37) years. In addition to the routine laboratory
tests, different markers of collagen synthesis and breakdown in serum
and SF were assessed. The radiological grade of the knee joint was
assessed by Larsen's method at the baseline and after a three year
follow up.
RESULTSDuring the
follow up, Larsen's grade deteriorated in 22 (40%) patients. These
patients had a significantly higher median level of cross linked
carboxyterminal telopeptide of type I collagen (ICTP) in SF at entry
than those who had a stable index (p = 0.035). Serum ICTP did not have
any predictive value for a specific joint. The median levels of total
SF leucocytes (p = 0.012) and the subgroup of polymorphonuclear
leucocytes (p = 0.018) were higher in the patients with a stable
Larsen's index. However, the relation of SF leucocyte level to
radiological progression could not be confirmed in the RA group.
CONCLUSIONIt is
concluded that SF analysis may help in the identification of patients
with inflammatory arthritis who are at risk for progressive destruction
in a particular joint. A high total SF leucocyte level is not
necessarily associated with a poor prognosis. Instead, a high SF ICTP
level seems to reflect accelerated bone degradation.
© 1999 by Annals of the Rheumatic Diseases
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
This article has been cited by other articles:
-
Swan, A, Amer, H, Dieppe, P
(2002). The value of synovial fluid assays in the diagnosis of joint disease: a literature survey. Ann Rheum Dis
61: 493-498
[Abstract] [Full Text] -
Amer, H., Swan, A., Dieppe, P.
(2001). The utilization of synovial fluid analysis in the UK. Rheumatology (Oxford)
40: 1060-1063
[Abstract] [Full Text]
- Full Text
- Full Text (PDF)
- Submit a response
- Alert me when this article is cited
- Alert me when eLetters are posted
- Alert me if a correction is posted
- Citation Map
Services
- Email this link to a friend
- Similar articles in this journal
- Similar articles in PubMed
- Add article to my folders
- Download to citation manager
- Request Permissions
Citing Articles
Google Scholar
PubMed
Topic Collections
-
Immunology (including allergy)
-
Degenerative joint disease
-
Musculoskeletal syndromes
-
Connective tissue disease
- Rheumatoid arthritis
Bookmark with
Register for free content
The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.
Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.
