A 35-year-old female telemarketer presents with complaints of pain in her right wrist for the past 6 months. She also reports having numbness in her right hand that occurs with wrist flexion or extension. For the past month, she has been receiving corticosteroid injections after her doctor diagnosed her with carpal tunnel syndrome. However, her pain has dramatically increased over the past week and has started to affect her job performance. Her mother has rheumatoid arthritis. Her hand appears to be swollen and is tender to palpation. She is scheduled for a synovial fluid aspiration. Which of the following findings in the aspirate would indicate surgical intervention?
(A) Glucose of 90 mg/ dL
(B) 1.8 × 103/ μL white blood cells/ mcl
(C) High abundance of rheumatoid factor
(D) Negatively birefringent crystals
(E) Thick yellow-green fluid