Cytology of urate milk in gouty arthritis:a case report
BACKGROUND: Synovial fluid (SF) analysis is a useful investigative procedurein the evaluation of various types of arthritides, including gouty arthritis. Rarely, goutyarthritis may present with effusion containing thick, milky white fluid. We report a case of goutyarthritis, describing cytologic features of the urate milk. CASE: A 42-year-old man presented withpain and swelling of multiple joints of long duration. Approximately 3 mL of milky white SF wasobtained for white blood cell (WBC) count, with a clinical diagnosis of septic arthritis. Due to thegross nature of the sample, the WBC count could not be performed; however, cytologic examination ofthe sample revealed a massive amount of classic, needle-shaped urate crystals on routinely stainedMay-Grunwald-Giemsa smears, favoring a cytologic diagnosis of gouty arthritis. CONCLUSION: Goutysynovitis occasionally presents with thick, milky white urate-laden synovial effusions, whichclinically may be mistaken for septic arthritis. This gross nature of the specimen may interferewith the performace of a WBC count on SF samples.
Siddaraju,N　Aier,M　Yaranal,PJ　Basu,D
Department of Pathology, Jawaharlal Institute of Postgraduate MedicalEducation and Research, Pondicherry, India. rajusiddaraju@yahoo.com
Arthritis　 Urate　 SF Brand of Topical Fluoride　 Milk Test, cytology,digestive
