Synovial fluid analysis
The uric acid test measures levels of uric acid that can collect in joint fluid. Uric acid is a normal bodily waste product. It forms when chemicals called purines break down. Purines are a natural substance found in the body and are also found in many foods such as liver, shellfish, and alcohol. They can also be formed in the body when DNA is broken down.
When purines are broken down to uric acid in the blood, the body gets rid of it when you urinate or have a bowel movement. But if your body makes too much uric acid, or if your kidneys aren't working properly, uric acid can build up in the blood. Uric acid levels can also increase when you eat too many high-purine foods or take certain medicines like diuretics, aspirin, and niacin. Then crystals of uric acid can form and collect in the joints, causing painful inflammation. This condition is called gout.
If you have gout, you may have crystals of uric acid in your synovial fluid, the substance that surrounds joints to help them move smoothly.
You may need this test if you have symptoms of gout:
Joint pain or tenderness
Swelling in a joint or reddened skin around a joint
Swelling and pain in the big toe, ankle, or knee
Joints that are hot to the touch
Swelling and pain that affects only one joint in the body
Skin that looks shiny and is red or purple
You may also need this test if you have symptoms of kidney stones. Symptoms include:
Severe pain along your lower back. This may repeatedly get worse and then ease up. The pain may also travel to your genitals.
Urgent need to urinate
Blood in your urine
Your healthcare provider may also order blood and urine tests to measure uric acid levels. Higher than normal levels of uric acid in the blood or urine can suggest gout. But the only way your provider can diagnose the condition for sure is by measuring the levels of uric acid in your synovial fluid.
Many things may affect your lab test results. These include the method each lab uses to do the test. Even if your test results are different from the normal value, you may not have a problem. To learn what the results mean for you, talk with your healthcare provider.
If your synovial fluid sample shows uric acid crystals, you may have gout. But even if your sample doesn't show uric acid crystals, you still may have gout. Crystals don't always form in the synovial fluid during a gout attack.
This test requires a sample of synovial fluid. It's collected during a process called joint aspiration. To collect the fluid, your healthcare provider inserts a needle into the skin near an inflamed joint and withdraws some of the surrounding fluid into a vial or tube.
Joint aspiration has some minor risks. You may have bleeding in the area around the joint. Although rare, an infection can develop in the joint from the test.
Certain medicines may affect your test results. They include:
Aspirin and other medicines that contain salicylate
Cyclosporine, a medicine sometimes used for autoimmune diseases
Levodopa, a medicine used to treat Parkinson disease
Certain diuretic medicines such as hydrochlorothiazide
Vitamin B-3 (niacin)
Other things that may affect your test results include:
Chemotherapy or radiation therapy to treat cancer
Foods high in purines. These include organ meats, mushrooms, some types of fish and seafood, and dried peas and beans
Ask your healthcare provider about what to do before having this test. You may need to avoid eating, drinking, or taking certain medicines on the day of the test. Be sure your provider knows about all medicines, herbs, vitamins, and supplements you are taking. This includes medicines that don't need a prescription and any illicit drugs you may use.