A biopsy of the synovial membrane in the diagnosis of arthritis

study biopsy specimens of synovium is currently widely used in the diagnosis of arthritis, allowing to optimize the treatment process.

synovial biopsy is done during arthroscopy of the affected joints by sampling small portions of tissue.Typically, the modified portions is visually synovium, which further examined using bacteriological, histological and cytological diagnostic methods.

Methods biopsy

  • diagnostic arthrotomy with an open biopsy (taking a piece of tissue during arthroscopic surgery) is performed most often in the defeat of one joint.
  • needle biopsy is performed in cases of suspected oncology or infectious disease, as well as in the defeat of multiple joints.

Tissue Diagnostics

  • With the help of this method is determined by the nature of the pathological process: inflammatory, degenerative-dystrophic, etc.(Synovitis, fibrinoid necrosis of urate crystals and calcium pyrophosphate, etc.)
  • Determination specificity lesions (disease specific symptoms) bacterial, viral or fungal in
    fection (tuberculosis, syphilis, Lyme disease, candidiasis, etc.)parasitic infections, collagenosis, metabolic disorders and neoplastic processes, etc.(Schistosomiasis, sarcoidosis, gout, chondrocalcinosis, amyloidosis, tumors, etc.).For example, by histological examination can reveal tubercles in tuberculous arthritis, friends, and the mycelium of fungi in fungal arthritis, mikrogummy congenital syphilitic arthritis, schistosome eggs in parasitic arthritis, etc.

cytological diagnosis

  • Usually this method of research in the biopsy specimens of synovium in all forms of chronic arthritis reveal typical signs of joint damage: hypertrophy (overgrowth) of synovial villi, the deposition on the surface of fibrin formation of follicles, foci of necrosis, sclerosisvascular fibrosis, synovial membrane and other changes.
  • In acute arthritis in the synovial membrane can be detected "fresh" inflammatory changes: enlargement and congestion of vessels, leukocyte infiltration, etc.
  • Specific changes in chronic metabolic and degenerative arthritis can determine the type of chronic process and its origin.Thus, for example, hemochromatosis in synoviocytes-cells is determined hemosiderin pigment deposition at chondromatosis - found in the synovium cartilage degeneration portions (metaplasia), etc.

Bacteriological examination

  • to isolate the causative agent crop is performed on special culture media.This makes it possible to identify a typical microflora, the causative agent of tuberculosis, fungi, etc.But this way is not determined by all kinds of infections.
  • Biological samples from infected laboratory animals (eg, for the diagnosis of syphilitic or tuberculous arthritis).
  • also used methods of immunofluorescent diagnostic PCR (polymerization chain reaction), impregnation (soaking) of silver preparations sections of the synovial membrane, carrying electron microscopy, and others.

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