Visual inspection of synovial fluid refers to the observation of synovial fluid in the presence of the naked eye. Synovial fluid, also known as synovial fluid, is secreted by synovial cells of the joint. The amount of synovial fluid in the normal joint cavity is very small. When the joint has inflammation and other diseases, the synovial membrane is often involved, and its normal chemical composition and cellular components change. Therefore, the analysis of the synovial fluid has practical clinical value for the diagnosis of joint diseases. .

Basic Information

Specialist classification: growth and development check classification: body fluid examination

Applicable gender: whether men and women apply fasting: not fasting

Reminder: Cavity puncture should be performed by an experienced clinician under strict aseptic procedures. Normal value

The amount (knee joint) <3.5ml, the color is clear yellow, the viscosity is very sticky, and the transparency is clear and transparent.

Clinical significance

Abnormal result

(1) Increase in amount of non-inflammatory, inflammatory or septic arthritis. A reduction in volume does not mean that there are no major joint lesions.

(2) color

Grass green rheumatoid arthritis, chronic effusion.

Blood (orange) pigmented villonodular synovitis.

White gouty arthritis is present when there is a large amount of crystallization.

Blood vitamin C deficiency (scurvy), hemophilia.

(3) Viscosity

1 increase hypothyroidism, neurological joint disease.

2 reduce inflammatory or edematous joint effusion.

(4) Transparency

1 opaque septic arthritis (pus cells), gout, calcium pyrophosphate deposition disease (false gout) (crystal or cellulose), chronic inflammatory joint effusion (rice body), brown yellow disease (dark black particles), Amyloidosis (white or yellow flakes floating).

2 mild turbid systemic lupus erythematosus, rheumatic fever, scleroderma.


Before the examination: Joint cavity puncture should be performed by an experienced clinician under strict aseptic procedures.

At the time of examination: the amount of fluid in the normal joint cavity is very small, about 2 ml or less, and the patient should cooperate with the doctor to take the work.

Not suitable for the crowd: no.

Inspection process

First, under sterile conditions, the joint cavity is puncture, and the joint fluid is taken out for routine examination and special examination. Routine examinations include visual inspection and microscopic examination.

The visual observations mainly included the color of the joint fluid, brightness, viscosity, spontaneous agglutination assay and mucin agglutination test. Normal joint fluid is a turbid liquid with a yellowish, clear, transparent color. It can contain a small amount of cellular components, and the white blood cell count is 200-750/mm3. If the white blood cells in the synovial fluid increase, the joint fluid can become white and turbid, and in severe cases, it can be purulent. Sometimes the turbidity and darkness of the joint fluid may be caused by a large amount of crystals, fibrin, and the like. Sometimes the slippery fluid is bloody joint fluid, which may be caused by synovial bleeding during puncture and certain hemorrhagic joint diseases. Joint diseases that can cause bloody joint fluids include joint trauma, neurological joint disease, hemorrhagic diseases (such as hemophilia), and tumors.

Not suitable for the crowd

Not suitable for people: people who need to be examined have systemic lupus erythematosus, rheumatic fever, scleroderma, gout, arthritis and other patients. Those without examination indications should not be tested.

Adverse reactions and risks

Infection: Pay attention to aseptic operation during puncture, pay attention to local cleaning after puncture, prevent water pollution and avoid infection.

Bleeding: Localized bleeding caused by damage to the local vascular tissue by the puncture needle should be avoided as far as possible.