+ Resolve Article
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter

+ Translate
+ Subscribe to Site Feed
GeoScience Most Shared ContentMost Shared Content

¿Es util la reevaluacion de cristales en el líquido sinovial?

, : ¿Es util la reevaluacion de cristales en el líquido sinovial?.

El recuento celular, el an lisis de cristales y el estudio microbiol gico del l quido sinovial (LS), son piezas claves en el diagn stico y manejo del derrame articular pues conducen a decisiones cl nicas y terap uticas. El an lisis de cristales suele realizarse en campo claro y con luz polarizada compensada (LPC). Depende de la experiencia del examinador y del n mero de cristales presentes. Para aumentar el rendimiento, se puede analizar el sedimento tras centrifugaci n. Hay autores que sugieren que la maduraci n in vitro de los cristales facilita su identificaci n tras 24 horas de la extracci n. Otros sugieren que dicha demora deteriora la muestra. Nuestro objetivo es valorar si el re-examen del LS a las 24 horas puede aumentar el rendimiento diagn stico para cristales. Se analizaron durante 4 meses las muestras de LS remitidas para su an lisis con LP y microscop a de campo claro; se realiz reevaluaci n a las 24 horas en todos los casos posibles. Recibimos 174 LS, de los cuales 138 (79,3%) fueron negativos para el primer an lisis y 36 positivos. En 84 casos (60,8%) se pudo realizar una evaluaci n a las 24 horas. En 10 casos (11,9%) se observaron cristales que no hab an sido vistos en el primer an lisis. Siempre se trat de cristales de pirofosfato c lcico dihidratado. El incremento de muestras positivas tras el segundo examen fue de un 27,8% (IC 95%: 13,1-42,4). El rean lisis de cristales en LS a las 24 horas debe considerarse en los casos de sospecha de artropat a microcristalina con primer examen negativo. White blood cell counts, analysis of crystals in synovial fluid (SF) and microbiological studies are key measurements in the diagnosis and management of joint effusion. The results may lead to clinical and therapeutic decisions. The diagnosis of crystals in SF, usually performed by examination with compensated polarised light microscopy (PL), is not easy. It depends on the experience of the examiner and amount of crystals in the sample, which is sometimes very small. In order to increase the performance, analysis may be performed on the sediment after centrifugation. Some authors suggest that due to in vitro maturation of crystals, they can be more easily identified 24hours after extraction. Others suggest that the sample deteriorates. We question whether re-examination of SF can increase the diagnostic yield of this test. Over a 4 month period we analysed crystals in SF received in the laboratory using a PL and ordinary light microscopy. Where this was possible, the SF was examined again after 24hours. We received 174 SF; 138 (79.3%) were negative for the first analysis. In 84 cases (60.8%) a re-evaluation could be made after 24hours by trained staff. In 10 cases (11.9%) crystals that had not been seen previously became apparent. In all cases they were calcium pyrophosphate dihydrate crystals. The number of positive fluids increased by 27.8% (95% CI: 13.1-42.4) after a second assay. The re-analysis of crystals in SF at 24hours should be considered in cases of high suspicion of microcrystalline arthropathy when the first test is negative.


Other references

Laschober R.; Stadlbauer W., 1990: Synthesis of 3 heptyl 2 4 1h 3h quinolinediones and 3 nonyl 2 4 1h 3h quinolinediones. 3-Alkl-3-hydroxy-2,4-(1H,3H)-quinolinediones 4, which are metabolites of some Pseudomonas species, were synthesized by oxidation of the corresponding 4-hydroxy-2(1H)-quinolones 3. By halogenation of 3 the 3-chloro- and 3-bromo-2,4-(1H,3H)-quinolin...

Lewis, N.; Albrecht, J.; Schnepf, M.; Hamouz, F.; Driskell, J.; Goertz, J., 1994: Vegetable choices and cookery methods of Nebraskans. A telephone survey of a random sample of adult Nebraskans was conducted to identify the vegetables they consumed and the methods they used to cook these vegetables. Subjects were called in the evening after the last meal of the day, and were asked...

Glodek, P., 1973: Performance capability of HYPOR swine in comparison to Landrace. Tierzuchter 25 (3) 102

Cursino, J.W.; Fine, B.S., 1976: A histologic study of calcific and noncalcific band keratopathies. One hundred five cases previously diagnosed as band keratopathy were reexamined. We found that band keratopathy was calcific noncalcific, or mixture of both. The noncalcific band was identified as elastotic degeneration of collagen, known clinical...

Tetreau, C.; Lavalette, D., 2005: Dominant features of protein reaction dynamics: conformational relaxation and ligand migration. Here, we review the dominant aspects of protein dynamics as revealed by studying hemoproteins using the combination of laser flash photolysis, kinetic spectroscopy and low temperature. The first breakthrough was the finding that geminate ligand re...

Arthur, W.; Blackburn, J., 1999: Limited variation in segment number in populations of Brachygeophilus truncorum and Geophilus insculptus in Northumberland and Durham. Bulletin of the British Myriapod Group. July; 15: 9-13

Andrejčáková, Z.; Sopková, Díra.; Vlčková, R.; Kulichová, L.; Gancarčíková, Sňa.; Almášiová, V.; Holovská, Kína.; Petrilla, Vír.; Krešáková, L., 2016: Synbiotics suppress the release of lactate dehydrogenase, promote non-specific immunity and integrity of jejunum mucosa in piglets. The aim of our experiment was to study how synbiotics are able to deal with the problems of post-weaning piglets. Lactobacillus plantarum - Biocenol(TM) LP96 (CCM 7512), Lactobacillus fermentum - Biocenol(TM) LF99 (CCM 7514) and flaxseed (rich in...

Knox, J.M.; Fraser, W.M., 1962: Topical use of amphotericin. Texas State Journal of Medicine 58: 415-416

Guo-Xin-Hong; Liu-Shao-Jun; Xiang-Bing; Liu-Yun, 2007: Variability of mitochondrial DNA of triploid hybrids of crucian carp and common carp. The article presented the results of the first regular population study of triploid hybrids of crucian carp and common carp by sequencing the tRNA-Thr gene, tRNA-Pro gene, and partial control region of mitochondrial DNA (mtDNA) The 26 sequenced f...

Fulton Kehoe, D.; Franklin, G.M., 1995: The burden of disability from carpal tunnel syndrome in Washington State workers compensation. Neurology 45(4 SUPPL 4): A464