Which of the following conditions typically does not present with a high level of WBCs in the synovial fluid?

Osteoarthritis typically does not present with a high level of white blood cells (WBCs) in the synovial fluid. In osteoarthritis, the inflammation is generally mild and the changes in the synovial fluid are not as pronounced as in other more inflammatory or infectious arthropathies.

In contrast, septic arthritis often presents with significantly elevated WBC counts due to infection, while both rheumatoid arthritis and gouty arthritis also characteristically show increased WBC levels, reflecting their inflammatory nature. In rheumatoid arthritis, the synovial fluid is often rich in inflammatory cells, including neutrophils and lymphocytes, indicating an autoimmune process. Gouty arthritis, resulting from the precipitation of urate crystals, similarly leads to a marked inflammatory response with elevated WBC counts in the synovial fluid.

Thus, osteoarthritis is distinct in having a relatively lower WBC count, consistent with its degenerative rather than inflammatory pathology.