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- Title
Persistence of Crystals in Stored Synovial Fluid Samples.
- Authors
Pastor, Sonia; Bernal, José-Antonio; Caño, Rocío; Gómez-Sabater, Silvia; Borras, Fernando; Andrés, Mariano; Andres, Mariano
- Abstract
<bold>Objective: </bold>Lack of access to polarized light microscopy is often cited as an argument to justify the clinical diagnosis of crystal-related arthritis. We assessed the influence of time since sampling and preservation methods on crystal identification in synovial fluid (SF) samples under polarized light microscopy.<bold>Methods: </bold>This was a prospective, longitudinal, observational factorial study, analyzing 30 SF samples: 12 with monosodium urate (MSU) crystals and 18 with calcium pyrophosphate (CPP) crystals. Each SF sample was divided into 4 subsamples (120 subsamples in total). Two were stored in each type of preserving agent, heparin or ethylenediamine tetraacetic acid (EDTA), at room temperature or at 4°C. Samples were analyzed the following day (T1), at 3 days (T2), and at 7 days (T3) by simple polarized light microscopy, and the presence of crystals was recorded.<bold>Results: </bold>The identification of crystals in the MSU group was similar between groups, with crystals observed in 11/12 (91.7%) room temperature samples and in 12/12 (100%) refrigerated samples at T3. Identification of CPP crystals tended to decrease in all conditions, especially when preserved with EDTA at room temperature [12/18 (66.7%) at T3], while less reduction was seen in refrigerated heparin-containing tubes.<bold>Conclusion: </bold>Preserving samples with heparin in refrigerated conditions allows delayed microscopic examination for crystals. Avoiding crystal-proven diagnosis because of the immediate unavailability of microscopy no longer appears justified.
- Subjects
MICROSCOPY; ARTHRITIS; SAMPLING (Process); SYNOVIAL fluid; DIAGNOSIS
- Publication
Journal of Rheumatology, 2020, Vol 47, Issue 9, p1416
- ISSN
0315-162X
- Publication type
journal article
- DOI
10.3899/jrheum.190468