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Dr Basu
Dr Basu, Experienced Specialist
Category: Medical
Satisfied Customers: 28149
Experience:  MD
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I just got back lab results of synovial fluid taken from my

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I just got back lab results of synovial fluid taken from my knees that have become increasingly swollen for the past 4 weeks. Left knee worse than right and whole left leg got very swollen before I asked them to take out fluid and give me cortisone injections There is over 18,000 total nucleated cells in the one knee and 13,000 in the other knee. Also the color is cloudy yellow. There is less than 1000 RBC in the first knee and over 1500 in the other. There were no crystals in the first knee but there were intracellular calcium pyrophosphate dihydrate crystals in the other knee fluid. I also have had swelling of 2 fingers and the bone joint at the bottom of my big toe. My CRP has been very high previously as well as concurrently with the knee swelling. I had colds, first one followed by a sinus infection and the second cold followed by pneumonia. Lyme blood test was negative and also negative for rheumatoid factor and autoimmune. MR Venogram of pelvis , abdomen and legs was normal. The lab messed up the culture of the synovial fluid that was ordered. Dr. put me on doxicycline twice a day I've been on it for a week and the swelling in the legs has very slowly decreased...not sure whether its from the antibiotic or not but he was concerned about a false negative lyme test. Other joints are about the same. Been running low grade fever on and off. Also very tired but don't sleep well due to pain from knees and legs. Could this be a serious systemic disease?
Submitted: 6 months ago.
Category: Medical
Expert:  Dr Basu replied 6 months ago.
Hi there,This is Dr Basu, experienced Internal Medicine Specialist.I am here to address your concerns and provide great service.Calcium pyrophosphate crystals suggest pseudogout.Pseudogout can cause joint inflammation.However you also have nucleated white blood cells.18000 is not that high, but still raises the question of joint infection.Joint fluid should be sent for bacterial culture.If confirmed, you will need IV antibiotics and also joint infusion with antibiotics.CRP level can be high from infection.Best wishes,It was my pleasure to help you today.If I have answered all your questions, Please rate my response Excellent (click on the 5th star on top).Please bookmark my profile for fast, reliable authentic answers!This is the link to my profile:

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