DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20172544

A prospective study for diagnosing joint diseases by synovial fluid analysis and percutaneous needle biopsy of synovium

Ganesh Kumar Reddy Mundla, Ramprasad Rallapalli, Sunil Santosh Galla, Biju Ravindran

Abstract


Background: Arthritis is an important cause of morbidity, presenting as monoarticular or polyarticular lesion. Percutaneous synovial aspiration and biopsy can help in identifying specific aetiological diagnosis. The study was conducted with the objective to evaluate the efficacy of percutaneous synovial biopsy as a diagnostic aid and study the characteristics of synovial fluid in various joint diseases.

Methods: Percutaneous synovial biopsy along with synovial fluid analysis was studied in all the 100 enrolled cases arthritis. The fluid was subjected to physical, biochemical, and cytological analysis.

Results: Of the 100 cases, monoarticular joint involvement predominated over polyarticular (n = 80; 80%), knee joint (60%) was most commonly affected in  monoarticular and polyarticular  arthrthritis. Rheumatoid arthritis (RA) (n=33; 33%)is the most common aetiology followed by tuberculosis (n=22). Males predominated over females in this study (n = 61; 61%).

Conclusion: The evaluation of synovial fluid and synovial biopsy in joint diseases will stimulate its use as routine investigative procedure in the diagnosis of various puzzling joint disorders. Both these procedures can be done simultaneously trough the same site of aspiration by the same needle.


Keywords


Joint diseases, Synovial fluid, Synovial biopsy

Full Text:

PDF

References


Kahlenberg JM, Fox DA. Advances in the medical treatment of rheumatoid arthritis. Hand Clin. 2011;27(1):11-20.

Vosse D, de Vlam K. Osteoporosis in rheumatoid arthritis and ankylosing spondylitis. Clinical and experimental rheumatology. 2009;27:62.

Sack K. Monarthritis: differential diagnosis. Am J Med. 1997;102:30.

Ma L, Cranney A, Holroyd-Leduc JM. Acute monoarthritis: what is the cause of my patient's painful swollen joint? CMAJ. 2009;180:59.

Siva C, Velazquez C, Mody A, Brasington R. Diagnosing acute monoarthritis in adults: a practical approach for the family physician. Am Fam Physician. 2003;68:83.

Pujalte GA, Albano-Aluquin SA. Differential diagnosis of polyarticular arthritis. Am Fam Physician. 2015;92(1):35-41.

Ropes MW, Bauer W. Synovial Fluid Changes in Joint Disease. Cambridge, Mass: Harvard University Press; 1953.

Verma R, Gupta SP, Vinod K. Place of synovial fluid examination and needle biopsy of synovial membrane in diagnosis of monoarticular joint diseases. Ind J Ortho. 1983;17(1):8-12.

Bhatia A, Kapoor S, Vishwakarma GK, Sagreiya K, Ashokraj G. Cytology as a diagnostic aid in arthritis. Indian J Med Res. 1981;73:761-7.

Sakhuja A, Singh S, Chaturvedi S, Bajpai J, Shukla R. Synovial fluid analysis and synovial biopsy in various types of arthritides. Indian J Orthopaed. 1981;15(2):157.

Gupta V, Sharma VK, Rao KS, Chandra R. Joint fluid analysis in arthritis- Clinico pathological study. Ind J Ortho. 1998;2(2):88-90.

Bresnihan B. Synovial biopsy in arthritis research: five years of concerted European collaboration. Ann Rheumatic Dis. 2000;59(7):506-11.

Vijay PM, Doddikoppad MM. Clinicopathological study of inflammatory synovial lesion. Int J Biol Med. 2011;2(4):882-8.

Venkataraman M, Sathyadharan P. Role of Needle Synovial Biopsy in Joint Diseases. J Evol Med Dental Sci. 2015;4(44):7626-34.

Singhal O, Kaur V, Kalhan S, Singhal MK, Gupta A, Machave YV. Arthroscopic synovial biopsy in definitive diagnosis of joint diseases: An evaluation of efficacy and precision. Int J App Basic Med Res. 2012;2:102-6.

Schumacher H, Kulka J. Needle Biopsy of the Synovial Membrane-Experience with the Parker–Pearson Technic. New Eng J Med. 1972;286(8):416-9.

Naib ZM. Cytology of synovial fluids. Actacytol. 1973;17(14):299-309.

Broderick PA, Corvese N, Pierik MG, Pike RF, Mariorenzi AL. Exfoliative cytology interpretation of synovial fluid in joint disease. J Bone Joint Surg. 1976;58(3):396-9.