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Rheumatology Advance Access originally published online on October 18, 2005
Rheumatology 2006 45(2):192-195; doi:10.1093/rheumatology/kei117
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© The Author 2005. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Diagnostic value of blind synovial biopsy in clinical practice

E. J. A. Kroot1,2, A. E. A. M. Weel2, J. M. W. Hazes2, P. E. Zondervan3, M. P. Heijboer4, P. L. A. van Daele5 and R. J. E. M. Dolhain2

1 Department of Rheumatology, St Franciscus Hospital and Departments of 2 Rheumatology, 3 Pathology, 4 Orthopaedics and 5 Internal Medicine, Erasmus MC, Rotterdam, The Netherlands.

Correspondence to: R. J. E. M. Dolhain, Erasmus MC, Department of Rheumatology, Z-712, PO Box 2040, 3000 CA Rotterdam, The Netherlands. E-mail: r.dolhain{at}erasmusmc.nl

Objective. To assess the diagnostic value of blindly performed synovial biopsies in carefully selected patients with unclassified arthritis.

Methods. Synovial tissue was obtained blindly under local anaesthesia. The Arthroforce III take-apart 3.5 mm needle and 1.5 mm grasping forceps were used for this purpose.

Results. Four patients with unclassified arthritis could be diagnosed properly based upon examination of synovial tissue of the knee obtained by an easy-to-perform blind biopsy. The arthritis of the four patients was diagnosed as being part of Erdheim–Chester disease, sarcoidosis, multicentric reticulohistiocytosis and arthritis caused by foreign-body material, respectively.

Conclusions. Analysis of synovial tissue obtained during a blind biopsy procedure has diagnostic potential in carefully selected patients with unclassified arthritis. The common denominator in all the cases presented was a differential diagnosis consisting of a rheumatological disease with characteristic histological features.

KEY WORDS: Blind biopsy, Synovial membrane, Diagnosis, Histology, Arthritis


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