A method for counting monosodium urate crystals in synovial fluid

Submitted: 5 May 2015
Accepted: 18 June 2015
Published: 30 June 2015
Abstract Views: 1814
PDF: 898
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This study was aimed to standardize the technique for counting monosodium urate (MSU) crystals in the synovial fluid (SF) of patients with gout. A total of 52 SF specimens were examined under a polarized light microscope. The amount of SF ranged between 0.1 and 45 mL (median 3 mL). MSU crystals were counted in four areas with the same size at 400x magnification. Cytological examination of the same specimens was also performed. Median leukocyte count was 400 cells/mm3 (range 50-14,000 cells/mm3), with a median percentage of polymorphonuclear leukocytes of 9% (range 0%-98%). Median crystal count was 179.5 (range 3-1600). Inter- reader and intra-reader agreement in crystal counting were good with a weighed k of 0.89 [95% confidence interval (CI) 0.85-0.94] and 0.89 (95% CI 0.84-0.93), respectively. Our data indicate that the SF MSU crystal count is a feasible and highly reliable technique.

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Montagna, P., Brizzolara, R., Ferrone, C., Cutolo, M., Paolino, S., & Cimmino, M. (2015). A method for counting monosodium urate crystals in synovial fluid. Reumatismo, 67(1), 29–32. https://doi.org/10.4081/reumatismo.2015.827