The role of synovitis in osteoarthritis

Abstract

Osteoarthritis (OA) is the most common form of arthritis worldwide yet there is still a lack of effective treatments for this condition. Increasingly, attention has turned to the role of the synovium in OA as it is now recognized, in part from the use of modern imaging techniques, that synovitis is both common and associated with pain. This offers a target for treatment, for both symptom and potential structure modification. In this review we discuss the evidence for histological and imaging-detected synovitis and the current role of antisynovial therapies in OA.

Serum and synovial fluid C-reactive protein level variations in dogs with degenerative joint disease and their relationships with physiological parameters

“…This synovitis is common in DJD patients, in early and late stages of the disease varying with it duration (Myers et al 1990;Loeuille et al 2005;Benito et al 2005;Wenham 2010) being important in cartilage degradation (Ayral et al 2005;Roemer et al 2009;Krasnokutsky et al 2007). Systemic inflammatory markers such as CRP (indicative of subclinical and clinical inflammation) are usually increased in serum of the DJD patients (Garnero and Delmas 2003).…”

“…Degenerative joint disease (DJD), also called osteoarthritis (Denny and Butterworth 2000), although is considered a non-inflammatory joint disease with a progressive and chronic nature, it is widely accepted that synovial inflammation is a common feature of it in early and late stages (Wenham 2010;de Lange-Brokaar et al 2012;Nair et al 2012). Although classified as a non-inflammatory disease, there is a significant regional inflammatory component (Piermattei et al 2006;Bennett 2010;Goldring 2000;Kapoor et al 2011), as large amount of pro-inflammatory cytokines (mostly synthesized by chondrocytes and synovial cells), increase the synthesis of proteases, cytokines, and other pro-inflammatory mediators that promote an acute phase proteins (APPs) response particular with a serum C-reactive protein (CRP) increase (Bennett 2010;Kapoor et al 2011;Cerón et al 2005).…”

An Intra-Articular, Extended-Release Formulation of Triamcinolone Acetonide Prolongs and Amplifies Analgesic Effect in Patients with Osteoarthritis of the Knee

“…Synovitis has been demonstrated with both histology and imaging technologies 30 and is recognized as an important element in the pathophysiology of the disease [3][4][5]30 . A number of longitudinal magnetic resonance imaging studies have directly correlated an increase in synovitis with worsening pain [31][32][33] .…”

“…Historically, osteoarthritis has been considered a mechanical disorder, but it is increasingly recognized that local inflammation, in particular, synovitis, is important in its pathophysiology [3][4][5] . Because synovitis is associated with both clinical symptoms and disease progression 4 , it is an important target for therapeutic intervention.…”

Ultrasound-detected inflammation predicts radiographic progression in hand osteoarthritis after 5 years

“…Synovial inflammation occurs in both early and late phases of OA,9 13 32 and is directly linked to clinical symptoms such as joint swelling and pain 17–20. Catabolic and proinflammatory mediators are produced in the inflamed synovium and alter the balance of cartilage matrix degradation and repair, leading to excess production of the proteolytic enzymes responsible for cartilage breakdown 9.…”