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Clinicopathological study of inflammatory synovial lesions

Authors:Vijay PM , Doddikoppad MM
Int J Biol Med Res. 2011; 2(4): 882 – 888  |  PDF File

Abstract

Aims: The aim of the present study is to study the morphology of various clinically suspected inflammatory lesions of the synovial tissue and its diagnostic utility. Methods: The present study comprises analysis of 83 biopsies of clinically suspected inflammatory synovial lesions conducted at Department of Pathology, J.J.M Medical College, Davangere during period of 2 years from April 2002 to March 2004 contributing 0.75% of 10,954 total specimens received during the period. Synovial biopsy Specimens were processed routinely and stained with haematoxylin and eosin and wherever necessary special stains like Z-N stain for AFB, Prussian blue stain for haemosiderin were carried out and diagnosed histopathologically. Wherever necessary the available clinical, radiological and synovial fluid analysis findings were taken in to consideration to categorize the lesions. Results: In our study, the common age groups affected were between 40-50yrs. Males were commonly affected with M: F 1:0.6. Most common symptoms seen were pain & swelling. Knee was the commonest joint involved. Most common histopathological diagnosis made among the clinically suspected inflammatory synovial lesions was chronic nonspecific synovitis followed by T.B arthritis, septic arthritis & rheumatoid arthritis. Conclusion: • High incidence of chronic non specific synovitis may represent smouldering infection where the causative agent was not demonstrable or represented an inflammatory response to local microtrauma or as an articular manifestation of a systemic disease. If these patients are closely followed up and repeat biopsies are performed, transition to definitive arthritis may occur. • In rheumatoid arthritis the histopathological features may be non specific suggesting the diagnosis of chronic non specific synovitis. However in many early rheumatoid arthritis patients with strong clinical or histopathological features suggestive of rheumatoid arthritis; it is worthwhile to do serological test for rheumatoid factor to exclude rheumatoid arthritis.