Clinicopathological study of synovial biopsies at tertiary care hospital and its diagnostic utility

Arthritis, an important cause for morbidity, is commonly found in clinical practice. Diseases such as tuberculous synovitis and gout need treatment directed towards specific diagnosis which can be achieved by the use of relatively simple technique of arthroscopic synovial aspiration and biopsy.

To study the histomorphological spectrum of different clinically suspected synovial lesions and to assess diagnostic utility of synovial biopsies.

The present study comprises analysis of 100 biopsies of clinically suspected synovial lesions during period of 4 years. Relevant clinical details were obtained. Synovial biopsy specimens were processed routinely and wherever necessary special stains like Z-N stain for AFB, Prussian blue stain for haemosiderin and immunohistochemical studies were carried out.. Wherever necessary the available clinical and radiological findings were taken into consideration to categorize the lesions. Lesions were classified under main categories of inflammatory joint diseases, degenerative joint disease, tumor and tumor like conditions.

In our study, the common age groups affected were between 40-60years. Both sexes were equally affected. Most common symptoms were pain and swelling. Knee was the commonest joint involved. Most common histopathological diagnosis made among the clinically suspected synovial lesions was chronic nonspecific synovitis followed by rheumatoid arthritis, septic arthritis& tuberculous synovitis. Also cases of benign tumors including synovial lipoma arborescence, chondromatosis, pigmented villonodular synovitis and malignant tumors like synovial sarcoma and clear cell sarcoma were noted in present study.

Histological analysis of synovial biopsies proves to be a valuable tool in establishing an early and specific diagnosis.