Summary
The correlation between arthroscopic observations and histologic changes in rheumatoid arthritis is still controversial. Synovial samples of 21 knee joints in rheumatoid arthritis patients were comparatively investigated by endoscopy and histology. Biopsies were scored by an endoscopist and subsequently dissected. Different histochemical and immunocytochemical staining techniques were used to define inflammatory activity. Arthroscopic and histological values were compared by rating scales and variance analysis. Our study indicates that synovial biopsy is of diagnostic value in rheumatoid arthritis. However, its usefulness depends on the histochemical methods used. The results revealed highly significant correlations of endoscopic features with the number of neutrophilic granulocytes, intravascular leukocytes, and peroxidase-positive macrophages. However, no relationship was found between the detection of lymphocytes or resident macrophages and inflammatory scores. The close correlation between endoscopic and histological findings suggests that arthroscopic evaluation allows a valuable classification of the inflammatory activity in rheumatoid synovitis.
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References
Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF (1988) The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31:315–324
Aul C, Heyll A, Schneider W (1991) Zytochemische Färbemethoden in der klinischen Hämatologie. Med Welt 42:171–180
Bromley M, Wooley DE (1984) Histopathology of the rheumatoid lesion: identification of cell types at sites of cartilage erosion. Arthritis Rheum 27:857–863
Clemmensen I, Holund B, Anderson RB (1983) Fibrin and fibronectin in rheumatoid synovial membrane and rheumatoid synovial fluid. Arthritis Rheum 26:479–485
Cooper NS, Soren A, McEwen C (1981) Diagnostic specifity of synovial lessons. Human Pathol 12:314–328
Harris Jr ED (1988) Pathogenesis of rheumatoid arthritis: a disorder associated with dysfunctional immunoregulation: In: JI Gallin, IM, Goldstein, R Snyderman (eds) Inflammation: basic principles and clinical correlates. Raven Press Ltd, New York, pp 751–773
Henderson DRF, Jayson MIF, Tribe CR (1975) Lack of correlation of synovial histology with joint damage in rheumatoid arthritis. Ann Rheum Dis 34:7–11
Hollingsworth JW, Siegel ER, Creasey WA (1967) Granulocyte survival in synovial exudate of patients with rheumatoid arthritis and other inflammatory joint diseases. Yale J Biol Med 39:289–294
Ikeuchi H (1982) In aid of understanding arthroscopic findings. Arthroscopy 7:93–95
Kitzis E, Weismann G (1991) The role of the neutrophil in rheumatoid arthrtis. Clin Orthop Rel Res 265:63–72
Kurosaka M, Ohno O, Hirohata K (1991) Arthroscopic evaluation of synovitis in the knee joints. Arthroscopy 7:162–170
Lansburry J (1956) Quantitation of activity of rheumatoid arthritis: method for summation of systemic indices of rheumatoid activity. Am J Med Sci 232:300–308
Lindblad S, Hedfors E (1985) Intraarticular variation in synovitis. Arthritis Rheum 28:977–986
Lindblad S, Hedfors E (1987) The synovial membrane of healthy individuals — the immunohistochemical overlap with synovitis. Clin Exp Immunol 69:41–47
Muirden KD, Mills KW (1971) Do lymphocytes protect the joint? Brit Med J 4:219–221
Rooney M, Condell D, Quinlan W, Lesliy D, Whelan A, Feighery C, Bresnihan B (1988) Analysis of the histologic variation of synovitis in rheumatoid arthritis. Arthritis Rheum 31:956–963
Williams JD, Scott DL, DeBrito FB, Willoughby DA, Huskisson EC (1986) Rheumatoid arthritis and joint destruction: cause and effect or parallel phenomena? Agents Actions 18:538–543
Yates DB, Scott JT (1975) Rheumatoid arthritis and joint disease: relationship between arthroscopic and histologic changes. Ann Rheum Dis 34:1–6
Young CL, Adamson TC III, Vaughan JH, Fox RI (1984) Immunohistologic characterization of synovial membrane lymphocytes in rheumatoid arthritis. Arthritis Rheum 27:32–39
Ziegler-Heitbrock HWL (1989) The biology of the monocyte system. Eu J Cell Biol 49:1–12
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Zschäbitz, A., Neurath, M., Grevenstein, J. et al. Correlative histologic and arthroscopic evaluation in rheumatoid knee joints. Surg Endosc 6, 277–282 (1992). https://doi.org/10.1007/BF02498859
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DOI: https://doi.org/10.1007/BF02498859