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Test Code BFCRY Crystals, Body Fluid

Infectious

Additional Codes

EPIC LAB4036

Purpose

Body fluids are submitted to the lab for analysis to ascertain the presence of infection, malignancy or a variety of disease states. Pleural and pericardial fluid may be submitted to differentiate chylous effusion from pseudochylous effusion. Differentiation may be determined by cholesterol levels and the potential presence of cholesterol crystals with pseudochylous effusion containing higher cholesterol levels. Synovial (collected from an arthrocentesis) fluid is submitted to help in the diagnosis of joint diseases such as gout. Examination of synovial fluid may differentiate infective arthritis from crystal-induced synovitis or if hemarthrosis is present.

 

Source: Strasinger, Susan King and Marjorie Schaub Di Lorenzo (2001). URINALYSIS and BODY FLUIDS (4th ed.). Philadelphia: F.A. Davis Company. Pg 182-1185.

Methodology

Compensated polarized light is used to identify the presence of crystals in an unstained, wet mount of synovial fluid. Slow moving and fast moving vibrations of light are produced by the compensator. Monosodium urate crystals show negatice birefringence and produce a yellow color when exposed to the slow-moving vibration whereas calcium pyrophophate crystals display positive birefringence and produce a blue color. The orientation of the crystal's slant (/ or \) determines which vibration of light (fast or slow) the crystals aligned with and consequently the color it reflects. Depending on the setting of the compensator, either parallel or perpinduclar to the axis, these slow and fast moving elements of the light can be reversed and the crystals will change color.

Sample Type

  • Synovial fluid
  • Pleural fluid
  • Pericardial fluid

 

Acceptable Tube Type(s)
Lavender top - EDTA
Dark green top - LiHep

Centrifuge: No

Specimen Minimum Volume

1 mL

Specimen Stability

Temperature Time
Ambient (18-25°C) 8 hours
Refrigerated (2-8°C) (store) 24 hours
Frozen (-15 to -20°C) N/A

 

Reference Ranges

Normal
Negative for crystals

Rejection Criteria

  • Unlabled specimens
  • Clotted specimens
  • Samples outside of stability limits
  • Specimens submitted in open/uncapped containers

Availability

Performed STAT
24/7 Yes

 

Performing Laboratory

MultiCare Yakima Memorial Hospital Laboratory

Lab Department

Hematology

CPT Code

89060

LOINC

6825-4 Crystals LM Nom (Body fld)