The utilization of synovial fluid analysis in the UK.
OBJECTIVE
To ascertain what use is being made of synovial fluid analysis in the UK, who is carrying out polarized light microscopy (PLM), and what confidence clinicians have in the results. Subjects and methods. A postal survey was developed, piloted, adjusted and then posted to 535 people, 90% of whom were senior rheumatologists and 10% orthopaedic surgeons, whose names had been obtained from professional lists.


RESULTS
Three hundred and eleven replies (59%) were obtained after 1 month. Analysis of the replies showed that only microbiological tests and PLM are used regularly, that these are used mainly for the diagnosis of acute arthritis, and that the majority of respondents would like data from these assays to be available within 24 h. The majority of the respondents (95%) had access to PLM and 80% said that clinicians should be able to use it. However, PLM is currently being undertaken by a variety of people: non-specialist technicians (34% of respondents), specialist technicians (35%) and clinicians (31%). Respondents were confident in microbiological assays but not in cell counts or PLM, unless they were undertaking it themselves.


CONCLUSIONS
There is an urgent need for guidelines, standardization and education about the use of synovial fluid assays in the UK.
Amer
H
H
SF Crystals Laboratory, University of Bristol, Department of Anatomy, School of Veterinary Science, Southwell Street, Bristol BS2 8EJ, UK.
Swan
A
A
Dieppe
P
P
D003460:Crystallization; D003625:Data Collection; D006801:Humans; D007958:Leukocyte Count; D008859:Microscopy, Polarization; D009140:Musculoskeletal Diseases / Q000175:diagnosis*; D009985:Orthopedics / Q000379:methods*; D012219:Rheumatology / Q000379:methods*; D011795:Surveys and Questionnaires; D013582:Synovial Fluid / Q000166:cytology* / Q000382:microbiology; D006113:United Kingdom