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Ultrasound-guided synovial biopsy: a safe, well-tolerated and reliable technique for obtaining high-quality synovial tissue from both large and small joints in early arthritis patients.
- Source :
-
Annals of the rheumatic diseases [Ann Rheum Dis] 2015 Mar; Vol. 74 (3), pp. 611-7. Date of Electronic Publication: 2013 Dec 13. - Publication Year :
- 2015
-
Abstract
- Objective: To determine the tolerability, safety and yield of synovial tissue in an early arthritis cohort using a minimally invasive, ultrasound (US)-guided, synovial biopsy technique in small, medium and large joints.<br />Methods: 93 sequential biopsy procedures were assessed from a total of 57 patients (baseline and 36 repeat biopsies at 6 months) recruited as part of the 'Pathobiology of Early Arthritis Cohort' study. Patients completed a tolerability questionnaire prior to and following the synovial biopsy procedure. The synovial biopsy was performed under US guidance with US images of the joint recorded prior to each procedure. Synovial tissue was harvested for immunohistochemistry and RNA extraction.<br />Results: Five different joint sites were biopsied (knee, elbow, wrist, metacarpal phalangeal and proximal interphalangeal). No significant complications were reported following the procedure. No difference in pain, swelling and stiffness of the biopsied joint from before and after the procedure was demonstrated. A median of 14 biopsy samples was retrieved from each procedure with 93% of biopsy procedures yielding good quality tissue. RNA yield was good in all joints and in repeat biopsies. Multivariant analysis demonstrated a significantly greater yield of RNA and graded tissue in relation to a high prebiopsy, grey-scale synovitis score (0-3, semiquantitative).<br />Conclusions: A minimally invasive approach to synovial tissue harvesting, using US guidance, is both safe and well-tolerated by patients. Tissue quality/RNA yield is preserved in subsequent biopsies following therapeutic intervention. A high US grey-scale synovitis score is a predictor of good quality/quantity of tissue and RNA.<br /> (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.)
- Subjects :
- Adult
Arthritis, Rheumatoid diagnostic imaging
Arthritis, Rheumatoid metabolism
Cohort Studies
Elbow Joint diagnostic imaging
Female
Hand Joints diagnostic imaging
Humans
Knee Joint diagnostic imaging
Male
Middle Aged
Prospective Studies
Synovial Membrane diagnostic imaging
Synovial Membrane metabolism
Synovitis diagnostic imaging
Synovitis metabolism
Ultrasonography
Arthritis, Rheumatoid pathology
Elbow Joint pathology
Hand Joints pathology
Image-Guided Biopsy
Knee Joint pathology
RNA analysis
Synovial Membrane pathology
Synovitis pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1468-2060
- Volume :
- 74
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Annals of the rheumatic diseases
- Publication Type :
- Academic Journal
- Accession number :
- 24336336
- Full Text :
- https://doi.org/10.1136/annrheumdis-2013-204603