Comparison of manual and automatic cell count methods for synovial fluid: A prospective study

Taner Alıç; Mustafa Şahin; Ünsal Savcı; Murat Çalbıyık; Hüseyin Kayadibi

doi:10.28982/josam.997894

Authors

Taner Alıç Department of Orthopaedics and Traumatology, Hitit University Erol Olçok Training and Research Hospital, Çorum, Turkey https://orcid.org/0000-0003-3848-8577
Mustafa Şahin Department of Medical Biochemistry, Hitit University, Erol Olçok Training and Research Hospital, Çorum,Turkey https://orcid.org/0000-0001-6073-563X
Ünsal Savcı Department of Microbiology, Hitit University Faculty of Medicine, Çorum, Turkey https://orcid.org/0000-0003-2319-8171
Murat Çalbıyık Department of Orthopaedics and Traumatology, Hitit University Faculty of Medicine, Çorum, Turkey https://orcid.org/0000-0001-5654-9500
Hüseyin Kayadibi Department of Medical Biochemistry, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey https://orcid.org/0000-0002-3922-4517

DOI:

https://doi.org/10.28982/josam.997894

Keywords:

Synovial fluid, Hematology analyzer, Cell count, WBC, RBC

Abstract

Background/Aim: Cell count measurement methods in the synovial fluid are still a current problem in orthopedic practice. Knowing the cell count in the synovial fluid is important for the assessment of a variety of orthopedic and rheumatologic diseases. We aimed to assess the correlation of WBC and RBC results obtained with a complete blood count analyzer with that obtained by a manual cell count. Methods: The WBC and RBC count in the synovial fluid of 43 patients undergoing gonarthrosis surgery were determined by a Mindray BC-6800 hematology analyzer. The study groups were defined as manual cell count (MC), hemogram mode (HM), and body fluid mode (BFM). All samples were analyzed twice consecutively, and the mean results were calculated. Cell counting was performed using different methods in the same samples and compared statistically. Results: The mean age of the patients was 60.9 years, and there were 17 males (39.5%) and 26 females (60.5%). The WBC and RBC counts in the synovial fluid samples were determined using manual cell count, and the HM and BFM on a Mindray BC-6800 automatic hematology analyzer. WBC counts significantly differed between MC and BFM, and RBC counts significantly differed between HM-MC and HM-BFM (P=0.001, P=0.001, P=0.001, respectively). There was a significant positive correlation between BFM and MC in WBC counts (r=0.633, P<0.001), with no statistically significant correlations identified between other methods. For RBC counts, there was a significant positive correlation between BFM and MC results (r=0.363, P=0.032). Conclusion: While the body fluid mode in hematology analyzers can be recommended for obtaining an RBC count in the synovial fluid, the hemogram mode may be recommended for the WBC count.

Downloads

Download data is not yet available.

References

Buoro S, Seghezzi M, Manenti B, Mecca T, Candiago E, Vidali M, et al. Reliability of automated synovial fluid cell counting with Mindray BC-6800 body fluid mode. International journal of laboratory hematology. 2017;39(3):337–46.

Sternbach GL, Baker FJ. The emergency joint: arthrocentesis and synovial fluid analysis. Journal of the American College of Emergency Physicians. 1976;5(10):787-92.

Cho J, Oh J, Lee SG, Lee YH, Song J, Kim JH. Performance Evaluation of Body Fluid Cellular Analysis Using the Beckman Coulter UniCel DxH 800, Sysmex XN-350, and UF-5000 Automated Cellular Analyzers. Annals of laboratory medicine. 2020;40(2):122-30.

Sandhaus LM. Body fluid cell counts by automated methods. Clinics in laboratory medicine. 2015;35(1):93-103.

Fleming C, Russcher H, Lindemans J, de Jonge R. Clinical relevance and contemporary methods for counting blood cells in body fluids suspected of inflammatory disease. Clinical Chemistry and Laboratory Medicine (CCLM). 2015;53(11):1689-706.

Karataş Ö, Tuncer T. Pseudo-septic arthritis developed after hyaluronic acid injection: A case report. J Surg Med. 2019;3(3):278-9.

Fuster O, Andino B, Pardo A, Laiz B. Continuous ambulatory peritoneal dialysis, ascitic and pleural body fluids evaluation with the Mindray BC-6800 hematology analyzer. Journal of Clinical Laboratory Analysis. 2018;32(2):e22240.

Pascual E, Batlle-Gualda E, Martínez A, Rosas J, Vela P. Synovial fluid analysis for diagnosis of intercritical gout. Annals of Internal Medicine. 1999;131(10):756-9.

Abdullah S, Young-Min, SA, Hudson SJ, Kelly CA, Heycock CR, Hamilton JD. Gross synovial fluid analysis in the differential diagnosis of joint effusion. Journal of Clinical Pathology. 2007;60(10):1144-7.

Brown W, Keeney M, Chin-Yee I, Johnson K, Lantis K, Finn W, et al. Validation of body fluid analysis on the Coulter LH 750. Laboratory Hematology: Official Publication of the International Society for Laboratory Hematology. 2003;9(3):155-9.

Punzi L, Oliviero F. Arthrocentesis and synovial fluid analysis in clinical practice: value of sonography in difficult cases. Annals of the New York Academy of Sciences. 2009;1154(1):152-8.

Walker TJ, Nelson LD, Dunphy BW, Anderson DM, Kickler TS. Comparative evaluation of the Iris iQ200 body fluid module with manual hemacytometer count. American Journal of Clinical Pathology. 2009;131(3):333-8.

De Smet D, Van Moer G, Martens GA, Nanos N, Smet L, Jochmans K, et al. Use of the Cell-Dyn Sapphire hematology analyzer for automated counting of blood cells in body fluids. American Journal of Clinical Pathology. 2010;133(2):291-9.

Brannan SR, Jerrard DA. Synovial fluid analysis. The Journal of Emergency Medicine. 2006;30(3):331-9.

Froom P, Diab A, Barak M. Automated evaluation of synovial and ascitic fluids with the Advia 2120 hematology analyzer. American Journal of Clinical Pathology. 2013;140(6):828-30.

Bourner G, De la Salle B, George T, Tabe Y, Baum H, Culp N, et al. International Committe for Standardization in Hematology (ICSH). ICSH guidelines for the verification and performance of automated cell counters for body fluids. International Journal of Laboratory Hematology. 2014;36(6):598-612.

Fleming C, Brouwer R, van Alphen A, Lindemans J, de Jonge R. UF-1000i: validation of the body fluid mode for counting cells in body fluids. Clinical Chemistry and Laboratory Medicine (CCLM). 2014;52(12):1781-90.

Fleming C, Russcher H, Brouwer R, Lindemans J, de Jonge R. Evaluation of Sysmex XN-1000 high-sensitive analysis (hsA) research mode for counting and differentiating cells in cerebrospinal fluid. Am J Clin Pathol. 2016;145(3):299–307.

Sandhaus LM, Dillman CA, Hinkle WP, Mac Kenzie JM, Hong G. A new automated technology for cerebrospinal fluid cell counts: comparison of accuracy and clinical impact of Glo Cyte, sysmex XN, and manual methods. American journal of clinical pathology. 2017;147(5):507-14.

De Jonge R, Brouwer R, Smit M, de Frankrijker-Merkestijn M, Dolhain RJEM, Hazes JMW, et al. Automated counting of white blood cells in synovial fluid. Rheumatology. 2004;43(2):170-3.

Cho YU, Chi HS, Park SH, Jang S, Kim YJ, Park CJ. Body fluid cellular analysis using the Sysmex XN-2000 automatic hematology analyzer: focusing on malignant samples. International journal of laboratory hematology. 2015;37(3):346-56.

Lim J. Usefulness of high fluorescence body fluid cell count (HF-BF%) in Automated hematology analyzer SYSMEX XN-350 for screening abnormal cells in body fluid analysis. The FASEB Journal. 2020;34(S1):1-1.

Lee J, Jeon K, Lee J, Kim M, Kim HS, Kang HJ, et al. Comparison of Body Fluid Differential Counts Using a Manual Counting Method or an Automated Hematology Analyzer. Journal of Laboratory Medicine and Quality Assurance. 2020;42(1):26-32.

Kerolus G, Clayburne G, Schumacher HR Jr. Is it mandatory to examine synovial fluids promptly after arthrocentesis? Arthritis Rheum. 1989;32(3):271–8.