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IP International Journal of Orthopaedic Rheumatology


Efficacy of synovial fluid analysis and synovial biopsy in diagnosing joint pathologies


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Author Details: Madhuchandra P.*,Sunil Santhosh G.,Raju K. P.

Volume : 4

Issue : 2

Online ISSN :

Print ISSN : 2581-8112

Article First Page : 61

Article End Page : 67


Abstract

Introduction: Joint disease is a common orthopaedic problem. They often occur in younger people and tend to be destructive. This can lead to widespread disability and morbidity. Diagnosis is clinical aided with conventional radiological and laboratory investigations. They are sometime equivocal and treatment is empirical and symptomatic.  The evaluation of synovial fluid and synovial biopsy should be an important part of investigative procedure in patients presenting with joint effusion.
Materials and Methods: Fifty patients with joint diseases visiting orthopaedic OPD and admitted at orthopaedic wards of BGS Global Institute of Medical Sciences, Bangalore formed the material of present study. Patients were informed about study in all respects and informed written consent was obtained. The period of study was from August 2013 to September 2016.  Detailed clinical and radiological screenings were done. This was followed by synovial fluid analysis and closed needle biopsy in each case. The result of this study was then compared with that of previous studies.
Results and analysis: A complete correlation between clinico-radiological, synovial fluid findings and closed needle biopsy for diagnosis of the definite pathology was seen in 34 (68%) cases. In 8 cases (16%) where the clinico-radiological and synovial analyses were equivocal and inconclusive, synovial biopsy only gave conclusive diagnosis of definite pathology. In another 8 cases (16%) the clinical radiological, synovial fluid findings and even the histologic study by closed needle biopsy were inconclusive for any definite disease and were labeled as chronic nonspecific synovitis. These cases were proved chronic nonspecific synovitis also by open biopsy.
Conclusion: Synovial fluid analysis and synovial biopsy will help in coming to a conclusive diagnosis in cases where radiological and laboratory investigations are equivocal. This can be done simultaneously through same site of aspiration with Parker Pearson needle. The significance of the result of the study outweighs the effort of the procedure. Thus it can be stated that 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.


Keywords: Synovial fluid, Joint diseases, Rheumatoid arthritis.

Doi :-https://doi.org/10.18231/2455-6777.2018.0015