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Rheumatology Advance Access published online on October 18, 2005
Rheumatology, 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
Received May 17, 2005
Accepted August 8, 2005

Original Papers

Diagnostic value of blind synovial biopsy in clinical practice

E. J. A. Kroot 1, A. E. A. M. Weel 2, J. M. W. Hazes 2, P. E. Zondervan 3, M. P. Heijboer 4, P. L. A. van Daele 5, and R. J. E. M. Dolhain 2*

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

* To whom correspondence should be addressed.
R. J. E. M. Dolhain, E-mail: r.dolhain{at}erasmusmc.nl


  Abstract

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.

Keywords: Blind biopsy; Synovial membrane; Diagnosis; Histology; Arthritis.
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