The Crucial Questions on Synovial Biopsy: When, Why, Who, What, Where, and How?

Frontiers in Medicine

article

Francesca Ingegnoli¹  Lavinia Agra Coletto¹  Isabella Scotti¹  Riccardo Compagnoni³  Pietro Simone Randelli³  Roberto Caporali¹ 

[1] Division of Clinical Rheumatology;Department of Clinical Sciences & Community Health, Research Center for Adult and Pediatric Rheumatic Diseases, Research Center for Environmental Health, Università degli Studi di Milano;1° Clinica Ortopedica;Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano;Laboratory of Applied Biomechanics, Department of Biomedical Sciences for Health, Università degli Studi di Milano

关键词: synovial biopsy;    synovial membrane;    rheumatoid arthritis;    inflammatory arthritis;    synovial analysis;   

DOI  :  10.3389/fmed.2021.705382

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

In the majority of joint diseases, changes in the organization of the synovial architecture appear early. Synovial tissue analysis might provide useful information for the diagnosis, especially in atypical and rare joint disorders, and might have a value in case of undifferentiated inflammatory arthritis, by improving disease classification. After patient selection, it is crucial to address the dialogue between the clinician and the pathologist for adequately handling the sample, allowing identifying histological patterns depending on the clinical suspicion. Moreover, synovial tissue analysis gives insight into disease progression helping patient stratification, by working as an actionable and mechanistic biomarker. Finally, it contributes to an understanding of joint disease pathogenesis holding promise for identifying new synovial biomarkers and developing new therapeutic strategies. All of the indications mentioned above are not so far from being investigated in everyday clinical practice in tertiary referral hospitals, thanks to the great feasibility and safety of old and more recent techniques such as ultrasound-guided needle biopsy and needle arthroscopy. Thus, even in rheumatology clinical practice, pathobiology might be a key component in the management and treatment decision-making process. This review aims to examine some essential and crucial points regarding why, when, where, and how to perform a synovial biopsy in clinical practice and research settings and what information you might expect after a proper patient selection.

【 授权许可】

CC BY