ROLE OF NEEDLE SYNOVIAL BIOPSY IN JOINT DISEASES

Joint disease is a common problem affecting all age groups presenting in orthopedic and rheumatology clinics. Diagnostic difficulties are encountered, particularly, in early stages when radiology and blood tests are inconclusive. The role of synovial analysis (Synovium and fluid) using the Parker Pearson technique was studied in 50 patients with various joint afflictions. There were 44 cases of monoarthritis and 6 cases of polyarthritis. Synovial fluid could be completely analyzed in 43 out of 50 cases and based on their physical, biochemical and cytological properties they were grouped as-a) Non inflammatory group b) Mild to moderate inflammation and c) Septic or severe inflammatory group. In this study, there were 6 cases of rheumatoid arthritis, 8 tuberculous arthritis, 16 non-specific synovitis, 4 traumatic arthritis, 4 osteoarthritis, 2 septic arthritis, 6 normal synovium and one each of gout, villo-nodular synovitis, neuropathic joint and AVN femoral head. With Parker Pearson needle and their technique adequate representative synovial tissue could be obtained for histopathology in 41 out of 50 (82%) cases. In the rest 9 cases, it was negative and open biopsy was done to reach a diagnosis. Closed needle synovial biopsy is a simple, cost effective outpatient procedure and a helpful adjuvant for the diagnosis of joint diseases.