ROUTINE SYNOVIAL-FLUID CULTURE - IS IT NECESSARY - LESSONS FROM AN AUDIT

An estimated third of rheumatologists send aspirated synovial fluid sa mples for culture routinely during the course of management of their p atients irrespective of the underlying diagnosis. This is done apparen tly even when sepsis is not suspected. This audit of 507 synovial flui d culture requests revealed that positive bacterial growth was rare ev en when sepsis was queried on the request forms but none was positive in any of the routine samples. Our findings throw doubt on the value o f routine synovial fluid culture. Mie recommend that such cultures are undertaken when infection is a possibility and in immuno-compromised patients. An average health district would save pound 3000 per annum i f such a policy was adopted, but across. the National Health Service a s a whole the total expenditure saved on this unnecessary investigatio n would be considerable.