Question

Consider the following statements regarding rheumatoid arthritis: 1. The synovial fluid is turbid. 2. Synovial fluid mucin clot test is good. 3. Synovial fluid complement level is decreased. 4. Synovial membrane histology characteristically shows severe synovial lining proliferation and presence of lymphoid follicles. Which of these statements are correct?

• A. 1, 2 and 3
• B. 1, 3 and 4
• C. 1, 2 and 4
• D. 2, 3 and 4

Hint:

One of the four statements describes the mucin clot the wrong way round - check that one closely.

Answer 1

The Correct Option is B

This question checks point-by-point knowledge of RA synovial fluid and synovial histology.

1. Statement 1, turbid fluid: true, the high inflammatory cell count makes RA synovial fluid cloudy.
2. Statement 2, good mucin clot: false, enzymatic degradation of hyaluronic acid makes the mucin clot poor in RA, the opposite of what is stated.
3. Statement 3, low complement: true, local complement consumption by immune complexes lowers synovial fluid complement levels.
4. Statement 4, lining proliferation with lymphoid follicles: true, this is the classic histologic picture of rheumatoid synovitis.

Combining the true statements, 1, 3 and 4, gives the correct option.

Correct answer: 1, 3 and 4.