title: Abnormalities in synovial fluid of patients with septic arthritis detected by gas-liquid chromatography.
abstract: Gas liquid chromatography was performed on synovial fluid of 94 patients with exudative arthritis. A relatively constant pattern of peaks was obtained in all synovial fluid samples. Lactic acid was increased in synovial fluid of patients with septic arthritis excluding gonococcal arthritis. In addition 2 constant peaks with retention time of 546 and 848 seconds in the chromatogram usually showed a significant increase in the synovial fluids of patients with septic arthritis (including gonococcal arthritis) but not in those from patients with sterile inflammatory or degenerative arthritis. In 1 patient with pseudomonas arthritis an increase in the peaks was noted with clinical and bacteriological relapse and subsequently there was a gradual return to normal levels during clinical improvement. Increase in synovial fluid lactic acid is useful in the diagnosis of septic arthritis. Identification of the compounds represented by the 2 peaks, which presumptively correspond to n-valeric and n-hexanoic acid, may provide further information on diagnosis, prognosis and pathogenesis of arthritis and may help in the differentiation between gonococcal and nongonococcal arthritis.
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001168:Arthritis / Q000175:diagnosis / Q000378:metabolism; D001170:Arthritis, Infectious / Q000175:diagnosis / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D002849:Chromatography, Gas; D003937:Diagnosis, Differential; D005232:Fatty Acids, Volatile / Q000032:analysis; D005260:Female; D006801:Humans; D007592:Joint Diseases / Q000378:metabolism; D007773:Lactates / Q000032:analysis; D008297:Male; D008875:Middle Aged; D013582:Synovial Fluid / Q000032:analysis*
chemical_list: D005232:Fatty Acids, Volatile; D007773:Lactates