Other causes of class II fluid include systemic rheumatic diseases, such as dermatomyositis and mixed connective tissue disease Still disease relapsing polychondritis postinfectious arthritis and the systemic vasculitides. In crystal-induced arthropathies, cell counts of 30,000–50,000 cells/mcL are typical, but ≥100,000 cells/mcL are sometimes observed. The cell counts in rheumatoid arthritis and the spondyloarthropathies are typically 5000–50,000 cells/mcL however, the pseudoseptic presentations of these disorders can generate higher counts (but rarely ≥100,000 cells/mcL). In systemic lupus erythematosus, white cell counts are usually between 2000 cells/mcL and 30,000 cells/mcL. The appearance of class II synovial fluid ranges from translucent to opaque and is yellow or white it is characteristic of noninfected, inflammatory forms of arthritis. Polymorphonuclear leukocytes predominate. Glucocorticoids from previous joint injections, talc from gloves, and even debris can form birefringent crystals and lead to mistaken diagnoses of microcrystalline disease.Ĭlass II (inflammatory) synovial fluid has white cell counts from 2000/mcL to 75,000/mcL, occasionally up to 100,000/mcL.
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