What does synovial fluid cytology show in cases of IMPA?

What does synovial fluid cytology show in cases of IMPA?

• A. Decreased nucleated cell count with degenerative neutrophils
• B. Increased total nucleated cell count, increase in non-degenerate neutrophils
• C. Increased eosinophils
• D. Predominantly lymphocytes

Answer: (B)

In immune-mediated polyarthritis, the joint becomes inflamed due to immune processes, leading to a neutrophil-predominant but sterile effusion. The key cytology feature is an elevated total nucleated cell count with neutrophils that are nondegenerate (normal-appearing neutrophils without toxic changes). This pattern differentiates IMPA from septic arthritis, where neutrophils are typically degenerate and bacteria may be seen. Eosinophils or predominantly lymphocytes are not the characteristic finding for IMPA. So, the best description is an increased cell count with nondegenerate neutrophils.

In immune-mediated polyarthritis, the joint becomes inflamed due to immune processes, leading to a neutrophil-predominant but sterile effusion. The key cytology feature is an elevated total nucleated cell count with neutrophils that are nondegenerate (normal-appearing neutrophils without toxic changes). This pattern differentiates IMPA from septic arthritis, where neutrophils are typically degenerate and bacteria may be seen. Eosinophils or predominantly lymphocytes are not the characteristic finding for IMPA. So, the best description is an increased cell count with nondegenerate neutrophils.