Percutaneous needle biopsy and synovial histology

Saaibi, Diego Luis; Schumacher, H. Ralph

doi:10.1016/s0950-3579(96)80048-3

Cited by 19 publications

(15 citation statements)

References 73 publications

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“…Thefirstreportofblind PNB of SM wasof apunchbiopsy technique performed in the human stifle jointinthe 1950s (29). In 1963, Parker andPearsondescribedanew, small-calibreP NB needlew hich facilitateds ampling of SM for histological examination in diseased joints (26).S incet hese earlyr eports, numerous articlesdescribingvarious techniques of PNB sampling andt he morphologicalc hangesa nd the pathophysiologyofsynovitis andarticularcartilage have been published (8,17,19,35,46). In aveterinary reviewa rticle,H ardy andW allace (13) mention the possibilityofPNB,but to the authors'k nowledge,a ni nvestigation into PNB sampling of SM in the veterinary fieldhas not been published.…”

Section: Discussionmentioning

confidence: 99%

“…Harvesting multiple samples (threet os ix biopsies) from the joint can compensatefor thesel imitations. Furthermore,S Ms ampling from various different joints in a single sitting butwith alimitedincrease in patient morbidity enhances the attractiveness of PNB for both clinical andr esearch purposes (34,35).…”

Section: Discussionmentioning

confidence: 99%

“…(Fig. 1).The technique used to obtain specimens wasthatde-scribedbyParkerand Pearson (26), andhas sincebeen used in avariety of studies (2,14,35,37,46). Thesamples were harvested by passing the outer cannula andtrocar into the distended joints pace.…”

Section: Study Populationmentioning

confidence: 99%

“…The histopathological changesi nt he SM have been documentedfor avariety of joint diseases (7,10,18,32,37). Synovitis, characterized by synovial cellproliferation and infiltration by lymphocytes, mononuclear cells,plasmacells,and polymorphonuclear cells,i so bservedw eeksb efore clinical signs of joint disease occurs (6,8,11,15,19,23,35,37).…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of different techniques for percutaneous needle biopsy of synovial membrane in the dog

Siegfried

Busato²,

Schawalder³

et al. 2005

Vet Comp Orthop Traumatol

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Four different needles were evaluated for percutaneous needle biopsy (PNB) of the synovial membrane (SM) in six different joints (carpus, tarsus, elbow, shoulder, stifle, hip) from eight dog cadavers. Needle biopsies were retrieved with the Parker-Pearson (PP), a novel modified Parker-Pearson (PPM), the Tru-Cut (TC), and the Franklin-Silverman (FS) needles. The success rate of PNB to produce biopsies, of adequate histological quality, was assessed for each needle type and joint. The joints were subsequently surgically opened and standard open SM biopsies were harvested from an adjacent area. The articular cartilage was inspected and graded for damage caused by PNB sampling. The length of the intact synovial lining cell layer (SLCL) and the histological quality of the needle biopsies were compared to the open surgical biopsies. Success rates for the different needles were 49.2% (PPM), 37.5% (PP), 26.7% (TC), and 1.7% (FS). The highest success rates were achieved in the carpus and stifle; the lowest success rate was found in the hip joint. The intact SLCL from the PNB samples was an average of 3.4 times shorter than that of the surgical biopsies. The proportion of the samples with adequate histological quality was 81% for open surgical biopsies and 62% for PNB samples. The FS was found to produce the highest incidence of articular cartilage damage. The application of PNB for SM sampling is a valuable alternative to the open surgical biopsy in dogs. Modifications of the Parker Pearson needle by Arassy and Schumacher and novel modifications introduced by the authors, offer encouraging results, and merit further clinical and research investigations.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Study Populationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Evaluation of different techniques for percutaneous needle biopsy of synovial membrane in the dog

Siegfried

Busato²,

Schawalder³

et al. 2005

Vet Comp Orthop Traumatol

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“…American College of Rheumatology (ACR) criteria for the diagnosis of rheumatoid arthritis (RA) have been used widely, but these criteria are not sufficiently effective for detecting early RA (2, 3). Synovial biopsy may reveal the typical histologic features of RA, but it does not provide specific features for RA and is rarely used because of its invasiveness (4). However, early diagnosis of RA is considered an important issue in order to prevent joint deformity and disability.…”

mentioning

confidence: 99%

Quantitative Assessment of Synovial Vascularity Using Contrast-Enhanced Power Doppler Ultrasonography: Correlation with Histologic Findings and MR Imaging Findings in Arthritic Rabbit Knee Model

et al. 2008

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ObjectiveTo validate contrast-enhanced power Doppler ultrasonography (PD US) for the evaluation of synovial vascularity in an arthritic rabbit knee model in correlation with MR and histological findings.Materials and MethodsPower Doppler ultrasonography was performed for carrageenin-induced arthritic left knee and control right knee of 13 rabbits, first without and then with sonic contrast agent enhancement (Levovist, Schering, Berlin Germany), followed by gadolinium-enhanced MR imaging. Synovial vascularity was quantitatively assessed by calculating the color pixel area in power Doppler sonography using a computer-aided image analysis program and by grading the enhancement on MR images: grade 1, enhancement of knee joint is less than one-third of the area; grade 2, one-third to two-thirds enhancement; and grade 3, more than two-thirds enhancement. Microvessel density (MVD) was measured on slides stained immunohistochemically for CD31 antigen for histological assessment.ResultsThe mean area of color pixels in PD US changed from 4.37 to 16.42 mm2 in the arthritic knee after enhancement (p < 0.05), whereas it changed from 0.77 to 2.31 mm2 in the control knee (p < 0.05). Arthritic knees had greater power Doppler signal than control knees both before and after contrast administration (p < 0.05). The average MVD was 88 in arthritic knees and 46 in control knees. MVDs correlated with color pixel areas of contrast-enhanced power Doppler imaging in arthritic knees. In MR grading of arthritic knees, five were grade 2 and eight were grade 3. MVD and PD US revealed no significant difference between grade 2 and 3 arthritic knees (p > 0.05).ConclusionSonic contrast-enhanced PD US improves the visualization of synovial vascularity and allows quantitative measurement in experimentally induced rabbit arthritic knees.

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Use of Ultrasound‐Guided Small Joint Biopsy to Evaluate the Histopathologic Response to Rheumatoid Arthritis Therapy: Recommendations for Application to Clinical Trials

Humby

Kelly

Hands

et al. 2015

Arthritis & Rheumatology

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Objective To examine in a cohort of rheumatoid arthritis (RA) patients undergoing serial ultrasound (US)–guided biopsies of small joints in the context of clinical trials whether sufficient synovial tissue could be obtained at both baseline and second biopsy to: 1) accurately evaluate the synovial immune phenotype, 2) permit adequate RNA extraction to determine molecular signatures, and 3) sensitively detect change in the number of synovial sublining macrophages (CD68+) following effective therapy. Methods Synovial samples from RA patients undergoing US‐guided biopsy of small joints as part of 2 clinical trials (Barts Early Arthritis Cohort [n = 18] and the Clinical and Pathological Response to Certolizumab Pegol (CLIP‐Cert) study [n = 17]) were examined, and the quality and quantity of histologic samples and RNA extracted per joint were determined and compared to synovial thickness and power Doppler scores determined by US before biopsy. Modulation of the number of CD68+ sublining macrophages was correlated with clinical response to treatment. Results Good quality synovial tissue that accurately reflected the synovial immune phenotype of the total joint was obtained in 80% of US‐guided procedures when synovial thickness (higher than grade 2) was documented before biopsy. In 100% of the procedures, sufficient RNA was extracted to permit molecular analysis. There was a significant correlation between change in CD68+ sublining macrophage number and clinical response to treatment. Conclusion This study provides minimum standards for sample retrieval for small joint biopsy. Furthermore, our findings confirm the clinical utility of the procedure in the largest reported cohort of US‐guided small joint biopsies. The demonstration that small joint synovial tissue can be readily accessed by a technically simple, minimally invasive procedure is likely to facilitate critical advancements in the knowledge of RA pathobiology and personalized health care.

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Percutaneous needle biopsy and synovial histology

Cited by 19 publications

References 73 publications

Evaluation of different techniques for percutaneous needle biopsy of synovial membrane in the dog

Evaluation of different techniques for percutaneous needle biopsy of synovial membrane in the dog

Quantitative Assessment of Synovial Vascularity Using Contrast-Enhanced Power Doppler Ultrasonography: Correlation with Histologic Findings and MR Imaging Findings in Arthritic Rabbit Knee Model

Use of Ultrasound‐Guided Small Joint Biopsy to Evaluate the Histopathologic Response to Rheumatoid Arthritis Therapy: Recommendations for Application to Clinical Trials

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