Gas Chromatography as a Potential Means of Diagnosing Arthritis. I. Differentiation between Staphylococcal, Streptococcal, Gonococcal, and Traumatic Arthritis

Studies were done to determine whether arthritis can be diagnosed by gas chromatographic examination of synovial fluids. Both acidic and basic extracts of synovial fluids from patients with well-documented cases of arthritis were studied. Heptafluorobutyric anhydride derivatives of these extracts were prepared and analyzed on a gas chromatograph equipped with an electron-capture detector. The gas chromatograms obtained were sufficiently dissimilar to permit differentiation between synovitis caused by trauma and that caused by staphylococcal, streptococcal, and gonococcal infections. In vitro studies included incubation of the bacterial isolates in control synovial fluids and comparison of resulting profiles with profiles obtained from the in vivo studies. Gas chromatography data from both the in vitro studies and studies of samples taken after effective antibiotic therapy indicated that many of the volatile components detected from diseased synovial fluids were metabolites of the pathogenic agent or metabolites of the host that had been modified by the presence of the parasite. The data suggest that gas chromatography might be used to help determine the etiology of various types of arthritis.