Laboratory Services
Information for Patients
The Rheumatology Service Laboratory is a Medical College of Wisconsin lab that is part of the Division of Rheumatology. It is directed by Lawrence Ryan, MD, Chief, Division of Rheumatology. The lab was created several decades ago in order to ensure that specialized tests, necessary for the diagnosis and treatment of patients with rheumatological disorders, are performed under the supervision of a physician who is board certified in Rheumatology. Tests are performed by a College of American Pathologist certified technologist that has over 20 years of specialized experience in Rheumatology laboratory work. This technologist is part of the team that is dedicated to caring for patients that are seen in the MCW Clinics and understands that serum and joint fluid analyses are a crucial part of your individualized care.
Information for HealthCare Workers
The Rheumatology Service Laboratory is a CLIA certified Medical College of Wisconsin lab that is part of the department of Medicine. The laboratory is located at Froedtert West Hospital, and is directed by Lawrence Ryan, MD, Chief, Division of Rheumatology.
Our mission is to provide reliable and accurate analysis of patient blood samples and joint fluids for physicians. We specialize in laboratory tests that are commonly ordered for patients with musculoskeletal diseases. Our particular expertise is detection and identification of joint fluid crystals. We currently accept specimens directly from outpatient Froedtert/MCW clinics and offsite referrals. In-patient joint fluids must be sent via Dynacare Labs. However, we are available to process and test joint fluids STAT during non-holiday weekdays (8:30 to 5:00), if the specimen is transported directly to this lab. You can contact the technologist at 805-2350 or page 907-6702. Analysis is completed within 15 minutes after receiving the specimen.
Test Menu
Serology
- RNP antibody by passive double immunodiffusion
- Smith antibody by passive double immunodiffusion
- Scl-70 antibody by passive double immunodiffusion
- ds-DNA antibody by Farr Assay
- ANA by HEp-2 immunofluorescence
- Rheumatoid Factor by rate nephelometry
- C3 and C4 by rate nephelometery
- CRP by rate nephelometry
- Albumin by rate nephelometry
- CCP antibody by ELISA
- ESR (sed rate) by Westergren
- SSA
- SSB
Joint Fluid Analysis
- Crystal Analysis by red compensated polarized light microscopy
- Synovial Analysis (includes crystal analysis, mucin clot, viscosity, and WBC & diff)
- WBC & differential
Guide for Interpreting Joint Fluid Analysis
MonoSodium Urate (MSU) crystals appear as negatively birefringent needle shaped crystals under red compensated polarized light microscopy.
Appearance of a typical MSU fluid (white arrow shows orientation of red compensator):
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Close-up View:  |
MSU Tophus:
Calcium PyroPhosphate Dihydrate (CPPD) crystals appear as positively birefringent rhomboidal crystals under red compensated polarized light microscopy.
Appearance of a typical CPPD fluid (white arrow shows orientation of red compensator):
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Close-up View:
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Cholesterol crystals appear as positively birefringent planar crystals with notched corners under red compensated polarized light microscopy.
Lipid Liquid crystals appear as positively birefringent tiny spheres under red compensated polarized light microscopy.
Injected corticosteroid crystals appear as brightly birefringent polymorphic crystals under red compensated polarized light microscopy. Steroids are usually unintentionally introduced into the fluid after the specimen is obtained. The presence of steroids in a fluid strongly interferes with crystal analysis and rarely can pathological crystals be detected and identified in these specimens.
