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. The purpose of this study was to determine the correlation between blood ethanol content and synovial fluid ethanol content. To this end, 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). BEC and 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. 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.
Forman, Katie and David Meredith. "Postmortem analysis of synovial fluid: An alternative method for determining the presence of ethanol." (2009). https://digitalrepository.unm.edu/ume-research-papers/59