Postmortem Analysis of Synovial Fluid: An Alternative Method for Determining the Presence of Ethanol
D Meredith, K Forman, M Barry, S Lathrop. University of New Mexico, School of Medicine, Albuquerque, NM; University of New Mexico Health Sciences Center, Albuquerque, NM
Background: Postmortem toxicological analysis is often an important tool in autopsy in determining the cause of death. There are circumstances however when traditional samples such as blood and vitreous fluid are unobtainable. In such instances, alternative body fluids such as synovial fluid may be useful adjuncts. However, synovial fluid has not been accepted as a widely used alternative. Earlier studies (Winek 1993, Ohshima 1997) demonstrated the potential for synovial fluid use in toxicological studies. The purpose of this study was to validate and determine the strength of correlation between blood ethanol content and synovial fluid ethanol content.
Design: Synovial fluid was obtained from 98 cases presenting to the Office of the Medical Investigator in Albuquerque, New Mexico over a 4 month period. Of these, 20 cases had measurable blood ethanol content at the time of demise, and were selected for use in the present pilot study to determine the viability of using synovial fluid as an alternative specimen for postmortem toxicology screening. Analysis of synovial fluid ethanol content (SEC) was performed using gas chromatography and compared with similarly obtained blood ethanol content (BEC).
Results: Blood ethanol content (BEC) and Synovial fluid ethanol content (SEC) were found to have a strongly positive linear relationship, with a Pearson correlation coefficient of 0.96 and a p-value of <0.0001.
Conclusions: The present study confirms prior research which indicates synovial fluid is a suitable substitute for the analysis of blood ethanol content particularly when traditional toxicology samples are unavailable, and synovial fluid can be adequately analyzed with current gas chromatograph protocols for volatile alcohols.
Monday, March 9, 2009 9:30 AM
Poster Session I Stowell-Orbison/Autopsy Award # 8, Monday Morning