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Analysis for crystals in synovial fluid: training of the analysts results in high consistency.
Ann Rheum Dis. 2005 Apr; 64(4):612-5.AR

Abstract

BACKGROUND

Identification of monosodium urate (MSU) and calcium pyrophosphate dehydrate (CPPD) crystals in synovial fluid samples is diagnostic of gout and CPPD crystal related arthropathy. Various studies have shown poor consistency in results of crystal analysis.

OBJECTIVE

To determine whether training of the analysts increases the consistency.

METHODS

An expert rheumatologist gave a course on crystal detection and identification. The four trained observers then blindly and independently examined synovial fluid samples previously classified by the expert which had been obtained from patients with both crystal arthropathies and other non-crystal related inflammatory joint conditions.

RESULTS

194 observations were made on 64 synovial fluid samples: 96 without crystals (49.4%), 55 with CPPD crystal (28.4%), and 43 with MSU crystals (22.2%). For crystal detection (presence or absence of crystals), sensitivity was 95.9% and specificity 86.5%. For identification of MSU crystals, sensitivity was 95.3% and specificity 97.2%. For identification of CPPD crystals, sensitivity was 92.7% and specificity 92.1%. The kappa index of agreement with the reference standard between the observers was 0.84 for any crystal detection, 0.93 for MSU crystal sample identification, and 0.79 for CPPD crystal sample identification.

CONCLUSIONS

For trained observers, the detection and identification of crystals in synovial fluid is a consistent procedure.

Links

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Authors+Show Affiliations

Lumbreras B
Department of Clinical Analysis, Hospital General Universitario de Alicante, Spain.
Pascual E
No affiliation info available
Frasquet J
No affiliation info available
González-Salinas J
No affiliation info available
Rodríguez E
No affiliation info available
Hernández-Aguado I
No affiliation info available

MeSH

ArthritisBiomarkersCalcium PyrophosphateChondrocalcinosisClinical CompetenceCrystallizationEducation, Medical, ContinuingGoutHumansMicroscopy, PolarizationObserver VariationProspective StudiesRheumatologySensitivity and SpecificitySpainSynovial FluidUric Acid

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15769916

Citation

Lumbreras, B, et al. "Analysis for Crystals in Synovial Fluid: Training of the Analysts Results in High Consistency." Annals of the Rheumatic Diseases, vol. 64, no. 4, 2005, pp. 612-5.
Lumbreras B, Pascual E, Frasquet J, et al. Analysis for crystals in synovial fluid: training of the analysts results in high consistency. Ann Rheum Dis. 2005;64(4):612-5.
Lumbreras, B., Pascual, E., Frasquet, J., González-Salinas, J., Rodríguez, E., & Hernández-Aguado, I. (2005). Analysis for crystals in synovial fluid: training of the analysts results in high consistency. Annals of the Rheumatic Diseases, 64(4), 612-5.
Lumbreras B, et al. Analysis for Crystals in Synovial Fluid: Training of the Analysts Results in High Consistency. Ann Rheum Dis. 2005;64(4):612-5. PubMed PMID: 15769916.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Analysis for crystals in synovial fluid: training of the analysts results in high consistency. AU - Lumbreras,B, AU - Pascual,E, AU - Frasquet,J, AU - González-Salinas,J, AU - Rodríguez,E, AU - Hernández-Aguado,I, PY - 2005/3/17/pubmed PY - 2005/4/26/medline PY - 2005/3/17/entrez SP - 612 EP - 5 JF - Annals of the rheumatic diseases JO - Ann Rheum Dis VL - 64 IS - 4 N2 - BACKGROUND: Identification of monosodium urate (MSU) and calcium pyrophosphate dehydrate (CPPD) crystals in synovial fluid samples is diagnostic of gout and CPPD crystal related arthropathy. Various studies have shown poor consistency in results of crystal analysis. OBJECTIVE: To determine whether training of the analysts increases the consistency. METHODS: An expert rheumatologist gave a course on crystal detection and identification. The four trained observers then blindly and independently examined synovial fluid samples previously classified by the expert which had been obtained from patients with both crystal arthropathies and other non-crystal related inflammatory joint conditions. RESULTS: 194 observations were made on 64 synovial fluid samples: 96 without crystals (49.4%), 55 with CPPD crystal (28.4%), and 43 with MSU crystals (22.2%). For crystal detection (presence or absence of crystals), sensitivity was 95.9% and specificity 86.5%. For identification of MSU crystals, sensitivity was 95.3% and specificity 97.2%. For identification of CPPD crystals, sensitivity was 92.7% and specificity 92.1%. The kappa index of agreement with the reference standard between the observers was 0.84 for any crystal detection, 0.93 for MSU crystal sample identification, and 0.79 for CPPD crystal sample identification. CONCLUSIONS: For trained observers, the detection and identification of crystals in synovial fluid is a consistent procedure. SN - 0003-4967 UR - https://www.unboundmedicine.com/medline/citation/15769916/Analysis_for_crystals_in_synovial_fluid:_training_of_the_analysts_results_in_high_consistency_ DB - PRIME DP - Unbound Medicine ER -