Ultrasound Guided Synovial Biopsy Using Portal and Forceps

Overview

Journal Ann Rheum Dis

Specialty Rheumatology

Date 2004 Nov 20

PMID 15550535

Citations 22

Authors

J M Koski

M Helle

Affiliations

Soon will be listed here.

Abstract

Objective: To describe a new method for taking a synovial biopsy specimen under ultrasound guidance using portal and forceps.

Methods: Percutaneous ultrasound guided biopsy was performed for 37 patients with mono- or polyarthritis as outpatients. A portal to a planned area was built using a needle, guiding wire, and dilators, through which forceps could be inserted and samples taken. Biopsy samples were taken from small and large joints, bursae, and tendon sheaths.

Results: Representative synovial tissue in adequate amounts for histopathological evaluation was obtained in 33/37 cases--a success rate of 89%. The biopsy procedures were well tolerated, but one complication of skin infection was encountered.

Conclusion: The new method of synovium biopsy under ultrasound guidance using sheath introducer set and flexible forceps can be performed on most joints and even bursae and tendon sheaths. The method gives sufficient samples for clinical work in most cases, but further work is needed before accepting this promising technique for scientific purposes.

Citing Articles

EULAR standardised training model for ultrasound-guided, minimally invasive synovial tissue biopsy procedures in large and small joints.

Moller I, Largo R, Bong D, Filer A, Najm A, Alivernini S RMD Open. 2025; 11(1.

PMID: 39832957 PMC: 11749067. DOI: 10.1136/rmdopen-2024-005065.

Precision Medicine in Rheumatology: The Promise of Ultrasound-Guided Synovial Biopsy, Barriers to Its Implementation in the United States, and Proposed Solutions.

Horowitz D, Mandelin A, Tabechian D, Ben-Artzi A Curr Rheumatol Rep. 2024; 26(6):197-203.

PMID: 38376666 DOI: 10.1007/s11926-024-01138-9.

Impact of the biopsy forceps size on histological analysis and performances of the histological scoring systems.

Bianchi E, Najm A, Vanbelle S, Le Goff B, Mutijima E, Kaiser M Sci Rep. 2022; 12(1):5692.

PMID: 35383240 PMC: 8983678. DOI: 10.1038/s41598-022-09704-w.

Early Diagnosis of Giant Solitary Synovial Chondromatosis of the Hip Using Ultrasound-guided Synovial Biopsy: A Case Report.

Jamshidi K, Khadem M, Shooshtarizadeh T, Mirzaei A Arch Bone Jt Surg. 2021; 9(2):235-239.

PMID: 34026943 PMC: 8121030. DOI: 10.22038/abjs.2020.43730.2200.

Ultrasound-Guided Synovial Biopsy: A Review.

Saraiva F Front Med (Lausanne). 2021; 8:632224.

PMID: 33968950 PMC: 8100029. DOI: 10.3389/fmed.2021.632224.

References

Rooney M, Condell D, Quinlan W, Daly L, Whelan A, Feighery C . Analysis of the histologic variation of synovitis in rheumatoid arthritis. Arthritis Rheum. 1988; 31(8):956-63. DOI: 10.1002/art.1780310803. View

Arnett F, Edworthy S, Bloch D, McShane D, Fries J, Cooper N . The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum. 1988; 31(3):315-24. DOI: 10.1002/art.1780310302. View

Dougados M, van der Linden S, Juhlin R, Huitfeldt B, Amor B, Calin A . The European Spondylarthropathy Study Group preliminary criteria for the classification of spondylarthropathy. Arthritis Rheum. 1991; 34(10):1218-27. DOI: 10.1002/art.1780341003. View

van Vugt R, van Dalen A, Bijlsma J . Ultrasound guided synovial biopsy of the wrist. Scand J Rheumatol. 1997; 26(3):212-4. DOI: 10.3109/03009749709065683. View

Dolhain R, ter Haar N, de Kuiper R, Nieuwenhuis I, Zwinderman A, Breedveld F . Distribution of T cells and signs of T-cell activation in the rheumatoid joint: implications for semiquantitative comparative histology. Br J Rheumatol. 1998; 37(3):324-30. DOI: 10.1093/rheumatology/37.3.324. View

Grassi W, CERVINI C . Ultrasonography in rheumatology: an evolving technique. Ann Rheum Dis. 1998; 57(5):268-71. PMC: 1752596. DOI: 10.1136/ard.57.5.268. View

Parker R, Pearson C . A simplified synovial biopsy needle. Arthritis Rheum. 1963; 6:172-6. DOI: 10.1002/art.1780060209. View

Baeten D, Van den Bosch F, Elewaut D, Stuer A, Veys E, de Keyser F . Needle arthroscopy of the knee with synovial biopsy sampling: technical experience in 150 patients. Clin Rheumatol. 2000; 18(6):434-41. DOI: 10.1007/s100670050134. View

Bresnihan B, Tak P, Emery P, Klareskog L, Breedveld F . Synovial biopsy in arthritis research: five years of concerted European collaboration. Ann Rheum Dis. 2000; 59(7):506-11. PMC: 1753183. DOI: 10.1136/ard.59.7.506. View

10.

Koski J . Ultrasound guided injections in rheumatology. J Rheumatol. 2000; 27(9):2131-8. View

11.

Tak P . Analysis of synovial biopsy samples: opportunities and challenges. Ann Rheum Dis. 2000; 59(12):929-30. PMC: 1753040. DOI: 10.1136/ard.59.12.929. View

12.

Tak P, Bresnihan B . The pathogenesis and prevention of joint damage in rheumatoid arthritis: advances from synovial biopsy and tissue analysis. Arthritis Rheum. 2001; 43(12):2619-33. DOI: 10.1002/1529-0131(200012)43:12<2619::AID-ANR1>3.0.CO;2-V. View

13.

Horton L, Jacobson J, Powell A, Fessell D, Hayes C . Sonography and radiography of soft-tissue foreign bodies. AJR Am J Roentgenol. 2001; 176(5):1155-9. DOI: 10.2214/ajr.176.5.1761155. View

14.

Kraan M, Reece R, Smeets T, Veale D, Emery P, Tak P . Comparison of synovial tissues from the knee joints and the small joints of rheumatoid arthritis patients: Implications for pathogenesis and evaluation of treatment. Arthritis Rheum. 2002; 46(8):2034-8. DOI: 10.1002/art.10556. View

15.

Matsuzaki S, Yoneda M, Kobayashi Y, Fukushima S, Wakitani S . Dynamic enhanced MRI of the subacromial bursa: correlation with arthroscopic and histological findings. Skeletal Radiol. 2003; 32(9):510-20. DOI: 10.1007/s00256-003-0655-8. View

16.

Schumacher Jr H, KULKA J . Needle biopsy of the synovial membrane--experience with the Parker-Pearson technic. N Engl J Med. 1972; 286(8):416-9. DOI: 10.1056/NEJM197202242860807. View

17.

Larsen A, Dale K, Eek M . Radiographic evaluation of rheumatoid arthritis and related conditions by standard reference films. Acta Radiol Diagn (Stockh). 1977; 18(4):481-91. DOI: 10.1177/028418517701800415. View

18.

Moon M, Kim I, Kim J, Lee H, Ahn Y . Synovial biopsy by Franklin--Silverman needle. Clin Orthop Relat Res. 1980; (150):224-8. View

19.

Beaule V, Laredo J, Cywiner C, Bard M, Tubiana J . Synovial membrane: percutaneous biopsy. Radiology. 1990; 177(2):581-5. DOI: 10.1148/radiology.177.2.2217803. View