Abstract
Objective : The utility of the cytological examination of synovial fluid (SF) was examined in the diagnosis of rheumatoid arthritis (RA), osteoarthrosis (OA), suppurative arthritis (SA) and pseudo gout (PG).
Study Design : Synovial tissues and SF were obtained from 31 cases with RA, 24 cases with OA, 6 cases with PG and 2 cases with SA and were examined. Synovial tissues from 7 cases with SA were also examined. RA cases were classified into active RA (19 cases) and inactive RA cases (12 cases). Macrophages were further classified into two types according to their morphology : (non foamy macrophages, NFM ; and foamy macrophages, FM).
Results : Specimens from the diseases examined were divided into two groups by the appearance of the neutrophils in the cytological preparations. Numerous neutrophils and solitary NFMs were found in active RA and SA cases. FMs were detected in SA cases, but were sparsely seen in active RA cases. On the other hand, neutrophils were rarely found in OA, PG and inactive RA cases. Numerous NFMs and fragments of synovial tissues containing NFMs were observed in OA, PG and inactive RA cases, but FMs were scarcely detected. Calcium pyrophosphate crystals were observed in 5 of 6 PG cases.
Conclusion : Cytological examination of SF using Papanicolaou stained preparations was thought to be useful in the diagnosis of RA, SA, OA and PG.
