Synovial fluid analysis

Alternative names
Joint fluid analysis; Joint fluid aspiration

Synovial fluid analysis is a battery of tests performed on synovial (joint) fluid to help diagnose and treat joint-related abnormalities.

How the test is performed

To obtain the fluid for analysis, a sterile needle is inserted into the joint space through skin that has been specially cleaned. Once in the joint, fluid is aspirated through the needle into a sterile syringe.

Synovial fluid is normally a viscous (thick), straw colored substance found in small amounts in joints, bursae, and tendon sheaths. In the laboratory, the fluid is initially analyzed for color and clarity. It is then examined microscopically for cells (red and white cells), crystals (in the case of gout), and bacteria. In addition, there may be a chemical analysis, and if infection is a concern, a sample will be cultured to see if any bacteria grow.

Abnormal joint fluid may look cloudy or abnormally thick.

How to prepare for the test

Normally, no special preparation is necessary, but contact your health care provider before the test to make sure.

Infants and children:
The preparation you can provide for this procedure depends on your child’s age, previous experience, and level of trust. For specific information regarding how you can prepare your child, see the following:

  • Infant test or procedure preparation (birth to 1 year)  
  • Toddler test or procedure preparation (1 to 3 years)  
  • Preschooler test or procedure preparation (3 to 6 years)  
  • Schoolage test or procedure preparation (6 to 12 years)  
  • Adolescent test or procedure preparation (12 to 18 years)

How the test will feel
Most health care providers will start by injecting local anesthesia with a small needle, which will sting. The aspiration is done with a larger needle and may also cause some pain. The procedure usually lasts less than one minute.

Why the test is performed

The test is performed to diagnose the cause of pain or swelling in joints, and to relieve pain from fluid accumulation (usually blood or pus) in the joint.

Common diseases diagnosed with fluid aspiration include infection, gout, and other inflammatory joint conditions. Blood in the joint may be an indication of trauma inside the joint or a systemic bleeding problem. An excess amount of normal synovial fluid can also be a sign of osteoarthritis.

What the risks are

  • Infection of the joint - unusual but more common with repeated aspirations  
  • Bleeding into the joint space

Special considerations
Ice or cold packs may be applied to the joint for 24 to 36 hours after the test to reduce the swelling and joint pain. Depending on the exact problem, you can probably resume your normal activities after the procedure. Talk to your health care provider to determine what activity is most appropriate for you.

Johns Hopkins patient information

Last revised: December 8, 2012
by Brenda A. Kuper, M.D.

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All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.