Polyarthritis following vaccination in four dogs

2003 ◽  
Vol 16 (01) ◽  
pp. 06-10 ◽  
Author(s):  
M. Garner ◽  
S. Lübke ◽  
M. F. G. Schmidt ◽  
D. Bennett ◽  
L. Brunnberg ◽  
...  
Keyword(s):  
Synovial Fluid ◽  
Clinical Signs ◽  
Sudden Onset ◽  
Clinical Findings ◽  
Type I ◽  
Fluid Analysis ◽  
Cell Counts ◽  
Synovial Fluid Analysis ◽  
University Of Berlin ◽  
Vaccination History

SummaryThe purpose of this study was to describe four dogs that developed polyarthritis (PA) shortly after vaccination.Between 1996–1999, 27 dogs were admitted to the Clinic for Small Animals, University of Berlin with clinical signs of PA. Based on the history, clinical findings, results of routine laboratory tests, radiography and ultrasonography, synovial fluid analysis, serum titers for rheumatoid factors, infectious disease and immunological serum titers nine dogs were diagnosed with idiopathic PA type I and 14 dogs with other forms of polyarthritis. Vaccine-associated PA (VAPA) was suspected in four dogs of different breeds (1.3–2.4 years old) which showed a sudden onset of lameness with several painful and swollen joints three – 15 days (mean 11) after vaccination. Synovial fluid analysis revealed nucleated cell counts ranging from 4,000-72,000/μl (mean 30,000) with 30–90% (mean 80) neutrophils. Treatment consisted of NSAIDs and doxycycline. The VAPA dogs quickly recovered in one to two days, three had not experienced a recurrent arthritic episode, one dog developed arthritic signs 12 days after revaccination. An accurate vaccination history is important on all dogs presenting with PA. In accordance with anecdotal reports the signs of disease in VAPA can spontaneously resolve.

scholarly journals MP031: Synovial fluid analysis in the diagnosis of septic arthritis: comparing local data to the literature

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S76-S77
Author(s):  
E. Logan ◽  
J. Fedwick
Keyword(s):  
Synovial Fluid ◽  
Septic Arthritis ◽  
Emergency Departments ◽  
Positive Culture ◽  
Diagnostic Algorithm ◽  
Clinical Findings ◽  
Gram Stain ◽  
Local Data ◽  
Fluid Analysis ◽  
Synovial Fluid Analysis

Introduction: A hot, painful, swollen joint is a common presentation to the emergency department. Of the potential etiologies, septic arthritis (SA) is the most devastating. Prompt diagnosis and treatment are essential to improve outcomes. Both culture proven and clinically suspected SA are thought to have the same prognosis, with similar morbidity and mortality estimates. No clinical exam or serum lab finding has the sensitivity or specificity to diagnose or exclude SA. Instead, diagnosis relies mainly on joint aspiration and synovial fluid analysis. A synovial white blood cell count (sWBC) greater than 50,000 cells/microliter is suggestive of SA and organisms seen on gram stain or growing in culture effectively makes the diagnosis. However, culture and gram stain are positive in only 67% and 50% of cases respectively. The objective of this study was to analyze the accuracy of synovial fluid analysis in our local practice environment. Methods: All those encounters with diagnoses related to SA at four adult emergency departments in Calgary between 2013-2014 were reviewed. Hospital records were analyzed for synovial analysis, antibiotic usage and surgical procedures. Results: Of 286 encounters, 87 were determined to satisfy the definition for SA in that culture was positive, gram stain was positive or clinical findings lead to treatment with antibiotics and/or surgical intervention. Gram stain was positive in 22% of cases with cultures positive in 51% of patients. sWBC were less than 50000 in 55% of cases and less than 25000 in 24% of cases. Of 88 gram stains performed, 28% were negative but had positive culture. All positive gram stains were associated with positive cultures. Conclusion: Culture, gram stain and sWBC of patients diagnosed with SA in Calgary show differences compared with the published literature. In Calgary, the majority of SA diagnoses were made clinically. The sWBC is central to making the diagnosis. Interestingly, 55% of patients diagnosed with SA had a count less than 50,000. It remains unclear what features of history, physical exam, imaging and lab analysis lead to the diagnosis of SA in these cases. Future studies will focus on these outliers to see if a more appropriate diagnostic algorithm would be useful in Calgary. Collaboration between infectious disease specialists, orthopedics, and emergency departments guided by local data is needed to ensure accurate and timely diagnosis.

scholarly journals Polyarthritis due to systemic lupus erythematosus in a dog

2013 ◽  
Vol 65 (2) ◽  
pp. 393-396 ◽  
Author(s):  
R.M. Krüger ◽  
R.T. França ◽  
A.S. Amaral ◽  
J.E.W. Schossler
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Synovial Fluid ◽  
Lupus Erythematosus ◽  
Antinuclear Antibody ◽  
Blood Count ◽  
Complete Blood Count ◽  
Clinical Signs ◽  
Systemic Lupus ◽  
Fluid Analysis ◽  
Synovial Fluid Analysis

A five year old male mongrel dog was presented for medical consultation with a history of arthralgia. Complete blood count revealed linfopenia and neutropenia, antinuclear antibody was positive at 1:1,256, and synovial fluid analysis showed inflammatory arthritis with lupus erythematosus cells. No significant proteinuria was detected on urinalysis, and microalbuminuria measurement was performed to determine glomerulonephritis in early stage. Based on clinical signs, synovial fluid analysis, antinuclear antibody test and complete blood count, the diagnosis was systemic lupus erythematosus. The measurement of microalbuminuria was useful to demonstrate the absence of glomerulonephritis, and the performance of complementary tests proved to be indispensable for diagnosis and prognosis. Glucocorticoid treatment led to complete remission.

Severe acute inflammatory reaction (SAIR) of the fetlock joint after intraarticular hyaluronate injection in a horse

2006 ◽  
Vol 19 (04) ◽  
pp. 236-238 ◽  
Author(s):  
J. M. Kuemmerle ◽  
H. Uhlig ◽  
J. Kofler
Keyword(s):  
Synovial Fluid ◽  
Inflammatory Reaction ◽  
Clinical Signs ◽  
Corticosteroid Treatment ◽  
Infectious Arthritis ◽  
Acute Inflammatory Reaction ◽  
Fluid Analysis ◽  
Synovial Fluid Analysis ◽  
Severe Inflammatory Reaction ◽  
Anti Inflammatory

SummaryHyaluronate (HA) was administered by intra-articular injection to a 13-year-old Haflinger mare for treatment of metacarpophalangeal osteoarthritis. Ten hours after the injection, a severe inflammatory reaction developed in the treated joint. While awaiting results of synovial fluid analysis, treatment for iatrogenic infectious arthritis was initiated, but the analysis did not confirm sepsis. Clinical signs improved significantly following systemic non-steroidal anti-inflammatory medication and the horse was discharged three days later. Following an intravenous hyaluronate injection, four days after discharge, the synovitis recurred. Synovial fluid analysis did not show any abnormalities, but the clinical signs were severe. The severe acute inflammatory reaction required systemic non-steroidal anti-inflammatory and intra-articular corticosteroid treatment in order to resolve the problem.

scholarly journals AB0629 ACCURACY OF SYNOVIAL FLUID ANALYSIS FOR THE IDENTIFICATION OF CALCIUM PYROPHOSPHATE CRYSTALS: AN ANCILLARY STUDY OF OMERACT CRITERION VALIDITY STUDY FOR ULTRASOUND IN CPPD

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1348.1-1348
Author(s):  
A. Adinolfi ◽  
S. Sirotti ◽  
M. Gutierrez ◽  
C. Pineda ◽  
D. Clavijo Cornejo ◽  
...  
Keyword(s):  
Synovial Fluid ◽  
Diagnostic Accuracy ◽  
Light Microscopy ◽  
Hyaline Cartilage ◽  
Microscopic Analysis ◽  
Calcium Pyrophosphate ◽  
Ancillary Study ◽  
Fluid Analysis ◽  
Synovial Fluid Analysis ◽  
Sensitivity Specificity

Background:Synovial fluid analysis (SFA) via compensated polarized light microscopy is still considered the gold standard for the identification and diagnosis of Calcium Pyrophosphate Deposition disease (CPPD)-related arthropathies[1], but very few studies have been published about its diagnostic accuracy.Objectives:The aim of this study was to evaluate the accuracy of SFA in the identification of calcium pyrophosphate dihydrate (CPP) crystals compared to microscopic analysis of joint tissues as the reference standard.Methods:This is an ancillary study of an international, multicentre cross-sectional study performed by the CPPD subgroup of the OMERACT Ultrasound working group[2]. Consecutive patients with knee osteoarthritis (OA) waiting for total knee replacement surgery were enrolled in the study from 2 participating centres, Mexico and Romania. During surgical procedures synovial fluid (SF), menisci and hyaline cartilage were collected and analysed within 48 hours after surgery under transmitted light microscopy and compensated polarised light microscopy for the presence/absence of CPP crystals. All slides were analysed by expert examiners on site, blinded to other findings. A dichotomic score (absence/presence) was used for scoring both SF and tissues. Microscopic analysis of knee tissues was considered the gold standard. Sensitivity, specificity, accuracy, positive and negative predictive values (PPV and NPV) of SFA in the identification of CPP crystals were calculated.Results:15 patients (53% female, mean age 68yo ± 8.4) with OA of grade 3 or 4 according to Kellgren-Lawrence scoring were enrolled. 12 patients (80%) were positive for CPP crystals at SFA and 14 (93%) at tissues microscopic analysis. Among 12 SFA positive patients, all were positive for CPP crystals in either medial or lateral meniscus, and 11 were positive in both; 10 patients were positive at the hyaline cartilage, and all 10 were also positive for at least one meniscus. Regarding the 3 SFA negative patients, only one had no crystals in the examined tissues, while the other 2 patients had CPP crystals in both menisci and hyaline cartilage. The overall diagnostic accuracy of SFA compared to histology analysis for CPPD was 87%, with a sensitivity of 86% and a specificity of 100%, the PPV was 100% and the NPV was 33% (Table 1).Table 1.sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy of synovial fluid analysis compared to the reference standard. CI: Confidential Interval. SF: synovial fluid, in parentheses: numerators and denominators for all percentages provided.SensitivitySpecificityPPVNPVAccuracySF analysis86% (12/14)100% (1/1)100% (12/12)33% (1/3)87% (13/15)(0.65-0.99) CI 95%(0.0-0.25) CI 95%(0.65-0.99) CI 95%(0.0-0.25) CI 95%Conclusion:SFA demonstrated to be an accurate test for the identification of CPP crystals in patients with advanced OA. However, is not always feasible and carries some risks for the patient. Considering the availability of validated imaging techniques for the detection of CPPD, such as US, SFA could be used in those patients where imaging and clinical data are not definitely confirmatory of the disease.References:[1]W. Zhang et al., ‘European League Against Rheumatism recommendations for calcium pyrophosphate deposition. Part I: terminology and diagnosis’, Ann Rheum Dis, vol. 70, no. 4, pp. 563–570, Apr. 2011, doi: 10.1136/ard.2010.139105.[2]G. Filippou et al., ‘Criterion validity of ultrasound in the identification of calcium pyrophosphate crystal deposits at the knee: an OMERACT ultrasound study’, Ann Rheum Dis, p. annrheumdis-2020-217998, Sep. 2020, doi: 10.1136/annrheumdis-2020-217998.Disclosure of Interests:None declared.

scholarly journals Lyme Arthritis: A Comparison of Presentation, Synovial Fluid Analysis, and Treatment Course in Children and Adults

2013 ◽  
Vol 65 (12) ◽  
pp. 1986-1990 ◽  
Author(s):  
Brian E. Daikh ◽  
Fred E. Emerson ◽  
Robert P. Smith ◽  
F. Lee Lucas ◽  
Carol A. McCarthy
Keyword(s):  
Synovial Fluid ◽  
Lyme Arthritis ◽  
Fluid Analysis ◽  
Synovial Fluid Analysis

Synovial fluid D-dimer concentration in horses with osteochondritis dissecans and osteoarthritis

2013 ◽  
Vol 26 (01) ◽  
pp. 54-60 ◽  
Author(s):  
L. Monreal ◽  
M. A. Delgado ◽  
J. Ríos ◽  
M. Prades ◽  
T. Ribera
Keyword(s):  
Clinical Study ◽  
Synovial Fluid ◽  
Clinical Significance ◽  
Osteochondritis Dissecans ◽  
Surgical Procedure ◽  
Fluid Analysis ◽  
Synovial Fluid Analysis ◽  
Pathway Activation ◽  
D Dimer ◽  
Coagulation And Fibrinolysis

Summary Objective: To assess the synovial fibrinolytic pathway activation in adult horses with developmental and degenerative arthropathies such as osteochondritis dissecans (OCD) and osteoarthritis (OA) by measuring synovial D-dimer concentrations. Methods: Prospective observational clinical study of horses admitted for OCD or OA. Synovial fluid was collected during lameness examination or prior to the surgical procedure, and D-dimer concentration and routine synovial fluid analysis were performed. Results: Fifty-eight horses (14 with OCD, 10 with OA and 34 controls) were included in this study. Synovial D-dimer concentrations of horses with OCD and OA were both higher when compared with controls, but were only significantly different in horses with OCD (p = 0.005). However, no statistical differences were observed when comparing synovial D-dimer concentrations from the OCD horses with the OA-affected horses (p = 0.444). Clinical significance: Activation of coagulation and fibrinolysis play a role in the pathophysiology of equine OCD and OA.

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