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Arthritis and Rheumatism

Synovial Fluid

08/31/2007

Question:

I have Crohn`s but have been in remission for 11 years. However, I tend to get swollen and sore joints a few months before a Crohn`s flare-up and recently had my right tumb, both feet and right knee act up.

My right knee swelled double its normal size with pain. After two weeks trying to manage this on my own, I went to my local urgent care doctor where he worked wonders by doing a knee tap and removing the fluid plus injecting me with cortisone.

The synovial fluid analysis of the knee came back with a total nucleated cell count high at 5722 and the appearance was marked as "turbid." Everything else seemed in range other than I have iron-deficient anemia.

What does the high nucleated cell count and the appearance of turbid mean exactly? Is this some sort of inflammatory arthritis condition possibly related to the Crohn`s or just a simple fluke of knee acting up?

Thanks for your help.

Answer:

I'm not sure what is meant by "total nucleated cell count". If it is the white blood cell count or the neutrophil count then the fluid is inflammatory in nature. Turbid is a gross description of the appearance of the fluid and is consistent with inflammation. The knee effusion is likely due to Crohn's related arthritis rather than a simple fluke.

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Response by:

Johnny Su, MD Johnny Su, MD
Formerly, Assistant Professor of Medicine
School of Medicine
Case Western Reserve University