Table 20.4-1. Synovial fluid analysis

Analyte/characteristics

Normal

Type I (noninflammatory)

Type II (inflammatory)

Type III (septic)

Volume (mL; knee joint)

<3.5

Often >3.5

Often >3.5

Often >3.5

Color

Colorless or straw-colored

Straw-colored or yellow

Yellow

Yellow-gray

Transparency

Completely transparent

Completely transparent

Slightly turbid or turbid

Turbid

pH

7.2-7.4

7.2-7.4

7.1-6.8

6.6

Viscosity (cP)

High (3-10)

High (3-10)

Decreased (<3)

Varied

Protein, total (g/dL)

1.8-2.1

2.99

4.19

5.6

Glucose concentration

As in serum

As in serum

Lower than in serum (difference <50 mg/dL)

Significantly lower than in serum (difference >50 mg/dL)

Ropes test

Solid precipitate

Solid precipitate

Flocky precipitate

Cloudiness

Cells/mm3

<200

200-2000

2000-75,000

Often >100,000

Granulocytes (%)

<25

<25

Often >50

>75

Bacteria (culture result)

Negative

Negative

Negative

Often positive

Adapted from Ropes MW, Bauer W. Synovial fluid changes in joint disease. Harvard University Press; 1953.

cP, centipoise.