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Test Code SFCHM Synovial Fluid Chemistries

Synonyms/Keywords

SF Protein, Glucose, Uric Acid

Specimen Requirements

Fasting Required	Specimen Type	Preferred Container/Tube	Acceptable Container/Tube	Specimen Volume	Specimen Minimum Volume (allows for 1 repeat)	Pediatric Minimum Volume (no repeat)
No	Synovial Fluid	Red Top Tube (RTT) or Sterile plain tube with no preservatives		1 mL	0.5 mL

Collection/Processing Instructions

1 mL synovial fluid to be collected in red top tube or sterile plain tube with no preservatives.

Cellular material should be separated from the fluid within 60 minutes by centrifugation.

Specimen Stability Information

Specimen Type	Temperature	Time
Synovial Fluid - Glucose	Refrigerate	7 days
Synovial Fluid - Total Protein	Refrigerate	3 days
Synovial Fluid - Uric Acid	Refrigerate	5 days

Rejection Criteria

Specimens collected in gel separator tubes

Test Components

Results will include specimen source, color, clarity, and quantitative results for glucose, protein, and uric acid.

Test Information

Results will include specimen source, color, clarity, and quantitative results for glucose, protein, and uric acid. If large numbers of leukocytes are present in synovial fluid then glucose should be tested within one hour for optimum results, as in-vitro glycolysis will falsely reduce the glucose concentration..

Reference Range Information

Performing Location	Reference Range
All Performing Sites	Color: Straw Clarity: Clear The Reference range has not been established for Glucose, Total Protein and Uric acid in synovial fluid. Results should be interpreted with simultaneous measurement of serum/plasma levels. Glucose: The SerumSynovial fluid difference <10 mg/dl in normal and non-inflammatory conditions. Proper interpretation of glucose requires comparison with fasting serum glucose. Total Protein: The reference interval proposed in literature is <3 g/dL. Measurement of total protein in synovial fluid is non-specific. Total protein sensitivity and specificity to detect inflammatory disorders is low. Uric Acid: Uric acids levels in synovial fluid generally but not always parallel serum uric acid levels in normal and non-inflammatory arthropathies. In inflammatory joint disorders uric acid levels may be significantly lower than in paired serum samples. Increased synovial fluid uric acid levels support the diagnosis of gout and are useful in suspected gout where crystals cannot be identified.

Performing Location

Reference Range

All Performing Sites

Color: Straw
Clarity: Clear
The Reference range has not been established for Glucose, Total Protein and Uric acid in synovial fluid. Results should be interpreted with simultaneous measurement of serum/plasma levels.

Glucose: The SerumSynovial fluid difference <10 mg/dl in normal and non-inflammatory conditions. Proper interpretation of glucose requires comparison with fasting serum glucose.

Total Protein: The reference interval proposed in literature is <3 g/dL. Measurement of total protein in synovial fluid is non-specific. Total protein sensitivity and specificity to detect inflammatory disorders is low.

Uric Acid: Uric acids levels in synovial fluid generally but not always parallel serum uric acid levels in normal and non-inflammatory arthropathies. In inflammatory joint disorders uric acid levels may be significantly lower than in paired serum samples. Increased synovial fluid uric acid levels support the diagnosis of gout and are useful in suspected gout where crystals cannot be identified.

Marshfield Labs Performing Department

Marshfield Labs Chemistry

Performing Information

Performing Location	Day(s) Test Performed	Analytical Time	Methodology/Instrumentation
Eau Claire	Monday through Sunday	Less than 2 hours	Siemens Dimension
Flambeau	Monday through Sunday	Less than 2 hours	Siemens Dimension
Marshfield	Monday through Sunday	Less than 2 hours	Beckman AU

CPT Codes

CPT	Modifier (if needed)	Quantity	Description	Comments
82945			Glucose, other than blood
84157			Protein
84560			Uric acid

Outreach CPT Codes

CPT	Modifier (if needed)	Quantity	Description	Comments
82945			Glucose, other than blood
84157			Protein
84560			Uric acid

Ordering Applications

Ordering Application	Description
Cerner	Synovial Fluid Chemistries Only

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