Synovial_fluid Synovial_fluid

Synovial fluid - Definition and Overview

Synovial fluid is a thick, stringy fluid found in the cavities of synovial joints. With its egg-like consistency (synovial comes from Latin for "egg") synovial fluid reduces friction between the articular cartilage in joints to lubricate and cushion them during movement.

Contents

Overview

The inner membrane of synovial joints is called the synovial membrane, which secretes synovial fluid into the joint cavity. This fluid forms a thin layer (approximately 50 micrometres) at the surface of cartilage, but also seeps into the articular cartilage filling any empty space [1] (http://www.ucl.ac.uk/~regfjxe/NORMALJOINT.htm). The fluid within articular cartilage effectively serves as a synovial fluid reserve. During normal movements, the synovial fluid held within the cartilage is squeezed out mechanically (so-called weeping lubrication) to maintain a layer of fluid on the cartilage surface.

Anatomy

Normal synovial fluid contains 3-4 mg/ml hyaluronan (hyaluronic acid), a polymer of disaccharides composed of D-glucuronic acid and D-N-acetylglucosamine joined by alternating beta-1,4 and beta-1,3 glycosidic bonds [2] (http://www.glycoforum.gr.jp/science/hyaluronan/HA01/HA01E.html). Hyaluronan is synthesized by the synovial membrane and secreted into the joint cavity to increase the viscosity and elasticity of articular cartilages and lubricate the surfaces between synovium and cartilage [3] (http://www.orthop.washington.edu/arthritis/general/joints/04).

Synovial fluid also contains lubricin secreted by synovial cells. It is chiefly responsible for so-called boundary-layer lubrication, which reduces friction between opposing surfaces of cartilage. There is also some evidence that it helps regulate synovial cell growth [4] (http://arthritis-research.com/content/5/S3/5).

Health and disease

Classification

Synovial fluid can be classified into normal, noninflammatory, inflammatory, septic, and hemorrhagic:

Classification of synovial fluid in an adult knee joint
Normal Noninflammatory Inflammatory Septic Hemorrhagic
Volume (ml) <3.5 >3.5 >3.5 >3.5 >3.5
Viscosity High High Low Mixed High
Clarity Clear Clear Cloudy Opaque Mixed
Color Colorless/straw Straw/yellow Yellow Mixed Red
WBC/mm3 <200 200-2,000 2,000-75,000 >100,000 Same as blood
Polys (%) <25 <25 >50 >75 Same as blood
Gram stain Negative Negative Negative Often positive Negative

Pathology

Many synovial fluid types are associated with specific diagnoses [5] (http://www.fpnotebook.com/RHE64.htm) [6] (http://www.rheumatology.org/publications/primarycare/number6/hrh0033698.asp?aud=mem):

External links and references

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